Active NPI
Shelby Spruill
- Physician Assistant
- Goldsboro, NC
National Provider Identifier
1376133769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2803 Medical Campus Drive
Goldsboro, NC 27531 - Phone
- (919) 722-1802
- NPI assigned
- Jan 20, 2021
- Last updated
- Jun 16, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2803 Medical Campus Drive
Goldsboro, NC 27531
Mailing address
1251 Montague Rd
Angier, NC 27501-7549
Phone (242) 548-2990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655337600000",
"number": "1376133769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1251 MONTAGUE RD",
"city": "ANGIER",
"state": "NC",
"postal_code": "275017549",
"telephone_number": "242-548-2990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2803 MEDICAL CAMPUS DRIVE",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "27531",
"telephone_number": "919-722-1802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRUILL",
"first_name": "SHELBY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-20",
"last_updated": "2022-06-16",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
- Shannon Ivy Speece, ANP
- Lori Diane Spisak, MD
- Donna Mercer Spivey
- Springwell, LLC (WellSpring, LLC)
- Sandra Spruill
- Venayagaratnam Srikantha, P.A.
- Ramaswamy Vellore Sriraman, M.D.
- SSC Goldsboro Operating Company LLC (Brian Center Health & Rehabilitation - Goldsboro)
- Samantha Michelle St John, FNP-C
- St. Vincent Home Care Services Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.