Active NPI
Carlton E. Spradley, RAS-I
- Addiction (Substance Use Disorder) Counselor
- Fairfield, CA
National Provider Identifier
1396997169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- RI-S0802201422
- Practice address
- 103 Bodin Cir
Fairfield, CA 94535-1801 - Phone
- (707) 437-1801
- NPI assigned
- Oct 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | RI-S0802201422 | CA | Primary |
Addresses
Primary practice location
103 Bodin Cir
Fairfield, CA 94535-1801
Mailing address
103 Bodin Cir
Fairfield, CA 94535-1801
Phone (707) 437-1801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 484838 | Other | CA | DRUG MEDICAL |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RI-S0802201422 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341273600000",
"number": "1396997169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 BODIN CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945351801",
"telephone_number": "707-437-1801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 BODIN CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945351801",
"telephone_number": "707-437-1801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRADLEY",
"first_name": "CARLTON",
"middle_name": "E.",
"credential": "RAS-I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-10",
"last_updated": "2012-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "RI-S0802201422",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRUG MEDICAL",
"identifier": "484838",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.