NPIMap

Individual provider Active NPI

John Michael Spine, D.O.

  • Family Medicine Physician
  • Erie, CO
National Provider Identifier
1356471593
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32971 Issued in CO
Practice address
720 Austin Ave
Suite 103
Erie, CO 80516-2422
Phone
(303) 828-9355
Fax
(303) 828-4883
NPI assigned
Mar 6, 2007
Last updated
Aug 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32971 CO Primary

Addresses

Primary practice location

720 Austin Ave
Suite 103
Erie, CO 80516-2422

Mailing address

720 Austin Ave
Suite 103
Erie, CO 80516-2422
Phone (303) 828-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406001226 CO Practitioner - Family Practice 6204725401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

720 Austin Ave
Suite 103
Erie, CO 80516-2422
Phone (303) 828-9355

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
32971COMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: doc@tricomd.directbygreenway.com

Organizations & group practices 1

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.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1356471593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 AUSTIN AVE",
            "address_2": "SUITE 103",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162422",
            "telephone_number": "303-828-9355",
            "fax_number": "303-828-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 AUSTIN AVE",
            "address_2": "SUITE 103",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162422",
            "telephone_number": "303-828-9355",
            "fax_number": "303-828-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINE",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "32971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, CO

Sources for this page

Verify at the official NPI Registry.