Active NPI
William E Spaine, PSY.D.
- Clinical Psychologist
- Fayetteville, AR
National Provider Identifier
1225064066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 99-10P
- Practice address
- 225 N East Ave
Fayetteville, AR 72701-5226 - Phone
- (479) 442-8900
- Fax
- (479) 442-8901
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 99-10P | AR | Primary |
Addresses
Primary practice location
225 N East Ave
Fayetteville, AR 72701-5226
Mailing address
225 N East Ave
Fayetteville, AR 72701-5226
Phone (479) 442-8900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2017 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99-10P | AR | MD | Clinical Psychologist |
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.
-
- Clinical Psychologist
- Fayetteville, AR
- NPI 1801807243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225064066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 N EAST AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727015226",
"telephone_number": "479-442-8900",
"fax_number": "479-442-8901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 N EAST AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727015226",
"telephone_number": "479-442-8900",
"fax_number": "479-442-8901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPAINE",
"first_name": "WILLIAM",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "99-10P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
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- Stephen Sparks, PHARM.D
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- Demetria Andreyelle Spearman
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.