Individual provider Active NPI

Laura G. Sporl, MD

  • Obstetrics & Gynecology Physician
  • Tacoma, WA
National Provider Identifier
1437171238
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD00047209 Issued in WA
Practice address
4215 49TH Ave NE
Tacoma, WA 98422-2421
Phone
(253) 459-7699
Fax
(253) 459-7675
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 10073R LA
Obstetrics & Gynecology Physician 207V00000X MD00047209 WA Primary

Addresses

Primary practice location

4215 49TH Ave NE
Tacoma, WA 98422-2421

Mailing address

4215 49TH Ave NE
Tacoma, WA 98422-2421
Phone (253) 459-7699

Other identifiers 5

IdentifierTypeStateIssuer
3374SPOtherWABLUE SHIELD VM
1686450MedicaidLA
5812274OtherWAAETNA SPECIALIST PIN VM
8481152MedicaidWA
P00394683OtherWARAILROAD MC # VM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, VI2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070411000496 WA Practitioner - Obstetrics/Gynecology 0547365066 Reassigns benefits to 1 organization
I20221117000068 VI Practitioner - Obstetrics/Gynecology 0547365066 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9946LAMDMental Health Counselor
10073RLAMDCardiovascular Disease Physician
MD00047209WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jun 1, 2009 Accepting new patients
Multicare Health System CurrentSince Jun 1, 2009 Accepting new patients
Multicare Health System Current Accepting new patients
Crescent City Physicians, Inc. Obstetrics & Gynecology Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

4215 49th Ave NE
Tacoma, WA 98422
Phone (253) 459-7699

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1437171238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 49TH AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984222421",
            "telephone_number": "253-459-7699",
            "fax_number": "253-459-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 49TH AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984222421",
            "telephone_number": "253-459-7699",
            "fax_number": "253-459-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORL",
        "first_name": "LAURA",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "10073R",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00047209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD VM",
            "identifier": "3374SP",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1686450",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN  VM",
            "identifier": "5812274",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8481152",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC # VM",
            "identifier": "P00394683",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.