Nicholas Spetko III, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

62678 Issued in TN

Practice address

108 Providence TRL
Mt Juliet, TN 37122-6578

Phone

(615) 466-0041

Fax

(615) 758-3791

NPI assigned

Aug 17, 2005

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, TN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Saint Thomas Medical Partners

  dba Ascension Medical Group Saint Thomas

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD
• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1235121047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PROVIDENCE TRL",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371226578",
            "telephone_number": "615-466-0041",
            "fax_number": "615-758-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PROVIDENCE TRL",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371226578",
            "telephone_number": "615-466-0041",
            "fax_number": "615-758-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPETKO",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "62678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeastern Dental of Mt Juliet PLLC
• Southern Home Care Services, Inc. (All Ways Caring HomeCare)
• Southern Home Care Services, Inc. (All Ways Caring HomeCare)
• Southern Spine and Sport LLC (Optimal Health Chiropractic)
• Chelsea M Sparkman, PA-C
• Jennifer L Spires, FNP-BC
• Sport Ortho Urgent Care PC
• Michelle McConnell Spradley
• Abigail Spruell
• Joanna Sroga, DPT, PT

• Internal Medicine Physician in Mount Juliet, TN
• Providers in Mount Juliet, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.