Individual provider Active NPI

Mark C Spangler

  • Diagnostic Radiology Physician
  • Kansas City, KS
National Provider Identifier
1275393928
Registry record updated Jun 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
94-12205 Issued in KS
Practice address
3901 Rainbow Blvd
Kansas City, KS 66160-1559
Phone
(909) 367-1979
NPI assigned
Mar 20, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 94-12205 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Kansas City, KS 66160-1559

Mailing address

2901 Saint Johns Blvd
Joplin, MO 64804-1598
Phone (417) 208-0786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20250614000288 KS Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 7315458676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
94-12205KSMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1275393928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SAINT JOHNS BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041598",
            "telephone_number": "417-208-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661601559",
            "telephone_number": "909-367-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANGLER",
        "first_name": "MARK",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "94-12205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.