Nicquia Spain, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102202803 Issued in VA

Practice address

4535 Spotsylvania Pkwy
Fredericksburg, VA 22408-7768

Phone

(540) 604-5186

Fax

(540) 604-5187

NPI assigned

Dec 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• William a Reese, MD LLC

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1841337839
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1235375007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 SPOTSYLVANIA PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224087768",
            "telephone_number": "540-604-5186",
            "fax_number": "540-604-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 SPOTSYLVANIA PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224087768",
            "telephone_number": "540-604-5186",
            "fax_number": "540-604-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAIN",
        "first_name": "NICQUIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-30",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT012545",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Source Fountain Wellness LLC
• Southpointe OBGYN, LLC
• Southside Internal Medicine of Fredericksburg PC
• Southside Primary Care, Inc.
• James Robert Spadoni, M.D.
• Stephanie J Spangler, MSW
• Brooke Renae Sparks, NP-C
• Ann K Spaulding, PA
• Spectrum Life Solutions
• Monica Spellman, PA

• Family Medicine Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.