John Michael Spore, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

N7593 Issued in AR

Practice address

901 Burnett Dr
Mountain Home, AR 72653-2908

Phone

(870) 425-9120

Fax

(870) 424-4470

NPI assigned

Aug 1, 2006

Last updated

Aug 27, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johnspore@osg.allscriptsdirect.net

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.

• Healogics Specialty Physicians of Arkansas, PLLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Fayetteville, AR
  • NPI 1538561436

  Surgery

  Medicare reassignment NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1275540502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BURNETT DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532908",
            "telephone_number": "870-425-9120",
            "fax_number": "870-424-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BURNETT DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532908",
            "telephone_number": "870-425-9120",
            "fax_number": "870-424-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORE",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "N7593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115393001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jo-Ann Sorokunov, RPH
• Nicholas Souder, M.D.
• Southern Home Healthcare Inc
• Kristopher Sperry
• Jennifer Ann Spore, R.D.
• Springfield Neurological and Spine Institute
• Springfield Neurological and Spine Institute
• Springfield Neurological and Spine Institute
• Stacey M Johnson MD PA (Physicians Medical Center of the Ozarks)
• Ray Emerson Stahl Jr., MD

• Surgery Physician in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.