Charles S Spillman Jr., PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

KY 885 Issued in KY

Practice address

800 Rose St RM C224
Lexington, KY 40536-0293

Phone

(858) 323-6346

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD
• Central Emergency Physicians, PSC

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1346371762
  Medicare reassignment
• Clark Emergency Physicians

  • Emergency Medicine Physician
  • Winchester, KY
  • NPI 1346781499
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment
• Acs Primary Care Physicians-Midwest

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1609811413

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1336274125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST RM C224",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-6346",
            "fax_number": "859-323-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST RM C224",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360293",
            "telephone_number": "858-323-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPILLMAN",
        "first_name": "CHARLES",
        "middle_name": "S",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "885",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "KY 885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamden L Spickard, BS, RBT
• Angela Christine Spiers, EDD, LPCC, LSW
• Tracy Spigelman, PHD, AT
• Spill the Tea, LLC
• Stacy Spiller
• Kirstin T Spillman, LPCC
• Spine and Brain Neurosurgical Care
• Spinesource America, L.L.C
• Mabel Spio, MD
• Natasha Layne Spires

• Surgical Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Surgical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.