Jessica Ann Spanbauer-Bales

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202004906NP-PP Issued in OR

Practice address

900 NE 27TH St
Bend, OR 97701-9548

Phone

(541) 382-0479

NPI assigned

Jun 25, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Daiya Healthcare PLLC

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1477027381
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1144847153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61266 HUCKLEBERRY PL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023357",
            "telephone_number": "541-550-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NE 27TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019548",
            "telephone_number": "541-382-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANBAUER-BALES",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202004906NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Physical Therapy, Inc.
• Jill Oxley Souto-Maior, R.D., L.D.
• Josie Sova, COTA/L
• Katie Sox
• Holly Spaman, RN
• Kelsey Marie Spanbauer, CPM, LDM
• Alexia Spanos, PH.D.
• Bonnie L Spatrisano, DC
• Carter Spear
• Anne M Speck, ATC

• Nurse Practitioner in Bend, OR
• Providers in Bend, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.