Jessica Spayd

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

4245, 677, 20608 Issued in AK

Legal business name

JESSICA SPAYD

Practice address

11823 Old Glenn Hwy
Suite 110
Eagle River, AK 99577-7734

Phone

(907) 622-4673

Fax

(907) 622-4674

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Jessica J Spayd, ANPNPI 1386602019

Title

Registered Agent

Phone

(907) 622-4673

Specialties & licenses 7

Addresses

Other identifiers 4

Other names 1

• Eagle River Pain & Wellness Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica J Spayd, ANP

  • Nurse Practitioner
  • Eagle River, AK
  • NPI 1386602019
  NPD (past) Authorized official

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1255465720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11823 OLD GLENN HWY",
            "address_2": "SUITE 110",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777734",
            "telephone_number": "907-622-4673",
            "fax_number": "907-622-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11823 OLD GLENN HWY",
            "address_2": "SUITE 110",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777734",
            "telephone_number": "907-622-4673",
            "fax_number": "907-622-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA SPAYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SPAYD",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "907-622-4673",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4245, 677, 20608",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "AK",
            "license": "4245, 677, 20608",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AK",
            "license": "4245, 677, 20608",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AK",
            "license": "4245, 677, 20608",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AK",
            "license": "4245, 677, 20608",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "AK",
            "license": "4245, 677, 20608",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AK",
            "license": "4245, 677, 20608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD42453",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP9295",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANP SPAYD NPI",
            "identifier": "1386602019",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. HEROLD'S NPI",
            "identifier": "1326187055",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle River Pain & Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kamran Rafique Janjua, M.D.
• Teri K. Jarnagin, DDS
• Anne Jarrett
• Heather Lynn Jasser, MS, CCC-SLP
• Desiree Jensen, LMT
• Taylor Joette Jock, CCC-SLP
• John D. Zipperer Jr MD, LLC
• John D. Zipperer, Jr., M.D., LLC
• Jennifer S Johnson
• Kimberly Ann Johnson, CCC/SLP

• Pain Medicine Physician in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Pain Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.