Individual provider Active NPI

David Wayne Spaulding

  • Physician Assistant
  • Barksdale Afb, LA
National Provider Identifier
1225366701
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
243 Curtiss Rd Ste 100
Barksdale Afb, LA 71110-2425
Phone
(318) 456-6555
NPI assigned
Nov 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

243 Curtiss Rd Ste 100
Barksdale Afb, LA 71110-2425

Mailing address

331 Sijen Ave
Whiteman Afb, MO 65305-1269
Phone (660) 687-7187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1780NEMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1225366701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SIJEN AVE",
            "city": "WHITEMAN AFB",
            "state": "MO",
            "postal_code": "653051269",
            "telephone_number": "660-687-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CURTISS RD STE 100",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102425",
            "telephone_number": "318-456-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAULDING",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-23",
        "last_updated": "2023-09-28",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barksdale Afb, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.