Craig C Spicer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2760 Issued in WV

Practice address

608 3Rd Ave
Saint Albans, WV 25177-1849

Phone

(304) 722-2906

Fax

(304) 722-6103

NPI assigned

Feb 9, 2007

Last updated

Jul 8, 2007By 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 WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316088867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 3RD AVE",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251771849",
            "telephone_number": "304-722-2906",
            "fax_number": "304-722-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 3RD AVE",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251771849",
            "telephone_number": "304-722-2906",
            "fax_number": "304-722-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "CRAIG",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "475146",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leann D Spangler, CRNA
• Melvin Daniel Spaulding
• April Spencer
• Britany Nicole Spencer, PRSS
• Tanille Marie Spencer, LMT
• Holli Spry
• St Albans Operating Company LLC (Riverside Health & Rehabilitation Center)
• St. Albans Integrative Health Center
• Desiree Beth Stambaugh
• Kristina Beth Stambaugh

• General Practice Dentistry in Saint Albans, WV
• Providers in Saint Albans, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.