NPIMap

Organization Active NPI

Brent W Spears MD PC

  • Legal Medicine
  • Farmingville, NY
National Provider Identifier
1326084302
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
Legal business name
BRENT W SPEARS MD PC
Practice address
107 Berkshire Dr
Farmingville, NY 11738-2003
Phone
(631) 834-8682
NPI assigned
Jun 20, 2006
Last updated
Oct 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Authorized official

Name
Dr. Brent W Spears, MD
Title
President
Phone
(631) 834-8682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X NY Primary

Addresses

Primary practice location

107 Berkshire Dr
Farmingville, NY 11738-2003

Mailing address

PO Box 502
Springtown, PA 18081-0502
Phone (631) 834-8682

Other identifiers 3

IdentifierTypeStateIssuer
147779OtherNYSTATE LICENSE NUMBER
017072OtherNYSUBMITTER ID NUMBER
34309OtherMAMASS MEDICAL LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1326084302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 502",
            "city": "SPRINGTOWN",
            "state": "PA",
            "postal_code": "180810502",
            "telephone_number": "631-834-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BERKSHIRE DR",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117382003",
            "telephone_number": "631-834-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT W SPEARS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "SPEARS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-834-8682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "147779",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBMITTER ID NUMBER",
            "identifier": "017072",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS MEDICAL LICENSE",
            "identifier": "34309",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.