Individual provider Active NPI

Michael K Spell, APRN-BC

  • Acute Care Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1285696740
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
670960 Issued in TX
Practice address
3070 College St
Suite 300
Beaumont, TX 77701-4691
Phone
(409) 813-1677
Fax
(409) 951-1690
NPI assigned
Apr 3, 2006
Last updated
Oct 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 670960 TX Primary

Addresses

Primary practice location

3070 College St
Suite 300
Beaumont, TX 77701-4691

Mailing address

3070 College St
Suite 300
Beaumont, TX 77701-4691
Phone (409) 813-1677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070129000710 TX Practitioner - Nurse Practitioner 1951302298 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Physician NetworkGroup PAC ID 0547333890, 121 clinicians

Practice addresses (Care Compare)

3080 College St
Beaumont, TX 77701-4606
Phone (409) 212-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
670960TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Intensivist Group PA CurrentSince Oct 17, 2022 Accepting new patients
Baptist Physician Network CurrentSince Jun 1, 2021 Accepting new patients
Southeast Texas Intensivists, PLLC CurrentSince Sep 1, 2023 Accepting new patients
JCH Inc PastSince Apr 1, 2021 Accepting new patients

Locations

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

3070 College St
Ste 120
Beaumont, TX 77701
Phone (409) 835-2300

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1285696740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 COLLEGE ST",
            "address_2": "SUITE 300",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014691",
            "telephone_number": "409-813-1677",
            "fax_number": "409-951-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 COLLEGE ST",
            "address_2": "SUITE 300",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014691",
            "telephone_number": "409-813-1677",
            "fax_number": "409-951-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELL",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "670960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.