NPIMap

Individual provider Active NPI

James Riley Spurlock III, D.O.

  • Family Medicine Physician
  • Woodbury, TN
National Provider Identifier
1376544767
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1506 Issued in TN
Practice address
370 Doolittle Rd
Suite 1
Woodbury, TN 37190-1129
Phone
(615) 563-3245
Fax
(615) 563-3247
NPI assigned
Aug 9, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 1506 TN Primary

Addresses

Primary practice location

370 Doolittle Rd
Suite 1
Woodbury, TN 37190-1129

Mailing address

370 Doolittle Rd
Suite 1
Woodbury, TN 37190-1129
Phone (615) 563-3245

Other identifiers 3

IdentifierTypeStateIssuer
1524159MedicaidTN
201365306OtherTNTAX ID
1522449MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20041006000267 TN Practitioner - Family Practice 7416916416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2001
Medicare assignment
May accept Medicare assignment
Group practices
James R Spurlock III DOGroup PAC ID 1355528126, 2 clinicians

Practice addresses (Care Compare)

370 Doolittle Rd
Woodbury, TN 37190-1129
Phone (615) 563-3245

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
James R Spurlock III DO Family Medicine CurrentSince Aug 1, 2004 Accepting new patients
Decatur County General Hospital Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Saint Thomas Stones River Hospital, LLC Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Cumberland River Hospital Inc Family Medicine Past Accepting new patients
Ocoee Foundation-CC LLC Past Accepting new patients

Locations

4712 Lascassas Pike
Lascassas, TN 37085
Phone (615) 603-7445

370 Doolittle Rd
Ste 1
Woodbury, TN 37190
Phone (615) 563-3245

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Woodbury Health and Rehabilitation CenterWoodbury, TN, CCN 445435 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 31, 2018
Dec 31, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Ocoee Foundation-CC LLC

    dba Woodbury Nursing and Rehabilitation Center

    • Skilled Nursing Facility
    • Woodbury, TN
    • NPI 1982876454

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 7

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 12

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376544767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 DOOLITTLE RD",
            "address_2": "SUITE 1",
            "city": "WOODBURY",
            "state": "TN",
            "postal_code": "371901129",
            "telephone_number": "615-563-3245",
            "fax_number": "615-563-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 DOOLITTLE RD",
            "address_2": "SUITE 1",
            "city": "WOODBURY",
            "state": "TN",
            "postal_code": "371901129",
            "telephone_number": "615-563-3245",
            "fax_number": "615-563-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPURLOCK",
        "first_name": "JAMES",
        "middle_name": "RILEY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524159",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "201365306",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522449",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, TN

Sources for this page

Verify at the official NPI Registry.