Spedale MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SPEDALE MD PC

Practice address

3113 Wesley Way Ste 1
Dothan, AL 36305-2004

Phone

(334) 699-5123

Fax

(334) 699-5125

NPI assigned

Sep 4, 2019

Last updated

Nov 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Roland Spedale Jr., MDNPI 1699778662

Title

Physician

Phone

(334) 699-5123

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Roland Spedale Jr., MD

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1699778662
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1184273096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 WESLEY WAY STE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363052004",
            "telephone_number": "334-699-5123",
            "fax_number": "334-699-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 WESLEY WAY STE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363052004",
            "telephone_number": "334-699-5123",
            "fax_number": "334-699-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEDALE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "SPEDALE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "ROLAND",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "334-699-5123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Ann Spann
• Lauren Spathias, DMD
• Spectracare Health Systems, Inc.
• Spectracare Integrated Services LLC
• Spectrum Center for Autism and Related Disorders, Inc (Spectrum)
• Anthony Roland Spedale Jr., MD
• Speechsolutions
• Mary Ella Spivey
• Nathan Spivey, M.D.
• Sherry Kate Springfield, LPTA

• Primary Care Clinic/Center in Dothan, AL
• Providers in Dothan, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.