Individual provider Active NPI

Phillip R Spangler, MD

  • Psychiatry Physician
  • Barboursville, WV
National Provider Identifier
1205897402
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20915 Issued in WV
Practice address
2 Chateau LN
Barboursville, WV 25504-1626
Phone
(304) 736-9662
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20915 WV Primary

Addresses

Primary practice location

2 Chateau LN
Barboursville, WV 25504-1626

Mailing address

97 Great Teays Blvd
Ste 6
Scott Depot, WV 25560-9815
Phone (304) 757-6999

Other practice location 1

97 Great Teays Blvd
Ste 6
Scott Depot, WV 25560-9815
Phone (304) 757-6999

Other identifiers 7

IdentifierTypeStateIssuer
2489883MedicaidWV
WV2714GOtherWVMEDICARE PTAN
WV2714HOtherWVMEDICARE PTAN
2006085000MedicaidWV
WV2714DOtherWVMEDICARE PTAN
WV2714FOtherWVMEDICARE PTAN
WV2714EOtherWVMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031220000067 WV Practitioner - Psychiatry 9032017645 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20915WVMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare, Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare, Inc CurrentSince Jan 25, 2016 Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc CurrentSince Nov 12, 2018 Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Psychiatry CurrentSince Feb 15, 2016 Accepting new patients
Womencare, Inc Current Accepting new patients

Locations

2 Chateau Ln
Barboursville, WV 25504
Phone (304) 736-9459

100 Florida St
Charleston, WV 25302
Phone (304) 348-6613

116 Hills Plz
Charleston, WV 25387
Phone (304) 720-4446

812 Park Ave
#35
Charleston, WV 25302
Phone (304) 720-4466

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

501 Stockton St
Charleston, WV 25387
Phone (304) 720-4466

503 Roosevelt Blvd
Eleanor, WV 25070
Phone (304) 586-0001

515 Main St
Madison, WV 25130
Phone (304) 369-0393

12 Kanawha Ter
Saint Albans, WV 25177
Phone (304) 201-1130

97 Great Teays Blvd
Ste 6
Scott Depot, WV 25560

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7363/brand/1/csg/1/fhir/r4

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1205897402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD",
            "address_2": "STE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609815",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHATEAU LN",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041626",
            "telephone_number": "304-736-9662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97 Great Teays Blvd",
            "address_2": "Ste 6",
            "address_purpose": "LOCATION",
            "city": "Scott Depot",
            "state": "WV",
            "postal_code": "255609815",
            "country_code": "US",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPANGLER",
        "first_name": "PHILLIP",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "20915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2489883",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV2714G",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV2714H",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006085000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV2714D",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV2714F",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV2714E",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barboursville, WV

Sources for this page

Verify at the official NPI Registry.