Individual provider Active NPI

James Steven Spangler, O.D.

  • Optometrist
  • Warren, PA
National Provider Identifier
1194749911
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG-000680 Issued in PA
Practice address
213 W 3Rd Ave
Ste. 106
Warren, PA 16365-2355
Phone
(814) 723-4470
Fax
(814) 723-4470
NPI assigned
Jul 26, 2006
Last updated
Nov 16, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG-000680 PA Primary

Addresses

Primary practice location

213 W 3Rd Ave
Ste. 106
Warren, PA 16365-2355

Mailing address

213 W 3Rd Ave
Warren, PA 16365-2355
Phone (814) 723-4470

Other identifiers 2

IdentifierTypeStateIssuer
410039073OtherRR MEDICARE
000769281MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090316000281 PA Practitioner - Optometry 1658438890 Practice locations: Warren, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG-000680PAMDOptometrist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1194749911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W 3RD AVE",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652355",
            "telephone_number": "814-723-4470",
            "fax_number": "814-723-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W 3RD AVE",
            "address_2": "STE. 106",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652355",
            "telephone_number": "814-723-4470",
            "fax_number": "814-723-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANGLER",
        "first_name": "JAMES",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG-000680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410039073",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000769281",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.