Active NPI
Joel S Spellun, M.D.
- Gastroenterology Physician
- Providence, RI
National Provider Identifier
1295785251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 7075
- Practice address
- 148 W River St
Suite 3
Providence, RI 02904-2609 - Phone
- (401) 421-6306
- Fax
- (401) 453-0330
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 7075 | RI | Primary |
Addresses
Primary practice location
148 W River St
Suite 3
Providence, RI 02904-2609
Mailing address
148 W River St
Suite 3
Providence, RI 02904-2609
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7003005 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7075 | RI | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565913600000",
"number": "1295785251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 W RIVER ST",
"address_2": "SUITE 3",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029042609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 W RIVER ST",
"address_2": "SUITE 3",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029042609",
"telephone_number": "401-421-6306",
"fax_number": "401-453-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELLUN",
"first_name": "JOEL",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2019-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "RI",
"license": "7075",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7003005",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.