Individual provider Active NPI

James S Spantgos, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, MO
National Provider Identifier
1376591776
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
080620 Issued in MO
Practice address
1333 S Sam Houston Blvd
Houston, MO 65483-2046
Phone
(417) 967-3311
Fax
(417) 967-3764
NPI assigned
May 5, 2006
Last updated
Dec 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X IL
Certified Registered Nurse Anesthetist 367500000X 080620 MO Primary

Addresses

Primary practice location

1333 S Sam Houston Blvd
Houston, MO 65483-2046

Mailing address

1333 S Sam Houston Blvd
Houston, MO 65483-2046
Phone (417) 967-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209003140ILMDCertified Registered Nurse Anesthetist
080620MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Granite City Clinic Corp Nurse Anesthetist, Certified Registered Past Accepting new patients
Vaughan Regional Medical Center LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Texas County Memorial Hospital Past Accepting new patients
Granite City Physicians Corp Past Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Vaughan Regional Medical Center LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1376591776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 S SAM HOUSTON BLVD",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654832046",
            "telephone_number": "417-967-3311",
            "fax_number": "417-967-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S SAM HOUSTON BLVD",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654832046",
            "telephone_number": "417-967-3311",
            "fax_number": "417-967-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANTGOS",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "080620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.