Jack Carlson Spies, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9601484 Issued in NC

Practice address

310 Long Shoals Rd
# 320
Arden, NC 28704-8794

Phone

(828) 274-6610

NPI assigned

Jul 19, 2006

Last updated

Oct 31, 2016By 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 NC

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 Osteopathy

State licenses

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.

• Western Carolina Family Practice PA

  • Family Medicine Physician
  • Asheville, NC
  • NPI 1063499838
  Authorized official Same address or phone

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1326067471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602373",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LONG SHOALS RD",
            "address_2": "# 320",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287048794",
            "telephone_number": "828-274-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIES",
        "first_name": "JACK",
        "middle_name": "CARLSON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9601484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8976916",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Sofie, RPH
• Sona Health Inc (LTC Sona Pharmacy Plus Clinic Arden)
• Michael Jude Sowa, O.D.
• Gretta Sowyrda, PTA
• Karl Richard Speers, D.O.
• Rita Marie Spragg, OTR
• Denise D Spring
• Brad Stansberry, APN
• Lori Ann Starr
• David Frank Stegall, P.A.

• Family Medicine Physician in Arden, NC
• Providers in Arden, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.