Roxanne R Sprague, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3711 Issued in MA

Practice address

759 Chestnut Street
Springfield, MA 01199

Phone

(413) 794-3233

NPI assigned

Jan 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Roxanne R. Blouin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1194901538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT STREET",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01199",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 CHESTNUT STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01199",
            "telephone_number": "413-794-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "ROXANNE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "3711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "BLOUIN",
            "middle_name": "R.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shanti Devi Sponder
• Rachel Elizabeth Sporbert
• Bethany Spracher, DO
• Adam A Sprague, PA-C
• Barbara K Sprague, PCNS
• Spring Street Drug Inc.
• Thomas Lawrence Spring, PHARMD, RPH
• Springfield Anesthesia Service, Inc.
• Springfield Chiropractic Sports Rehab Ctr LLP
• Springfield Dentistry and Braces, PC

• Medical Physician Assistant in Springfield, MA
• Providers in Springfield, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.