Nathaniel Spurgeon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.008832 Issued in IL

Practice address

812 N Logan Ave
Danville, IL 61832-3752

Phone

(217) 443-5000

NPI assigned

Nov 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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.

• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1518984210
  Medicare reassignment
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Apache Junction, AZ
  • NPI 1205273406

  Physician Assistant

  NPD
• Kennekuk Emergency Physicians LLC

  • Emergency Medicine Physician
  • Danville, IL
  • NPI 1659523777
  NPD (past)

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1386300275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 HILLSBORO PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372151338",
            "telephone_number": "661-549-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323752",
            "telephone_number": "217-443-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPURGEON",
        "first_name": "NATHANIEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "008831",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Randall Sooley, DC
• Southern Illinois Healthcare Foundation Inc
• Speak2Me2 Counseling LLC
• Amanda Spezia, APN
• Yvonne Marie Sprouse, RN
• Brooke Heather Sroufek, MS,RD,LD
• Karen Jo Stanley, RD LDN
• Therese A Stasik, PSY.D.
• Nichole Steinsdoerfer, MHP
• Stephanie Stephenson

• Physician Assistant in Danville, IL
• Providers in Danville, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.