NPIMap

Individual provider Active NPI

Scott Steven Spore, M.D.

  • Urology Physician
  • Lubbock, TX
National Provider Identifier
1447334867
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
K2124 Issued in TX
Practice address
418 N Utica Ave
Lubbock, TX 79416-3035
Phone
(806) 771-5882
Fax
(806) 687-9002
NPI assigned
Oct 24, 2006
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X K2124 TX Primary

Addresses

Primary practice location

418 N Utica Ave
Lubbock, TX 79416-3035

Mailing address

418 N Utica Ave
Lubbock, TX 79416-3035
Phone (806) 771-5882

Other identifiers 3

IdentifierTypeStateIssuer
134316208MedicaidTX
8F5901OtherTXBLUE CROSS BLUE SHIELD
124581101OtherTXFIRSTCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101115000945 TX Practitioner - Urology 1759471030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Texas Medical School at San Antonio, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock Urology Clinic, LLPGroup PAC ID 9436122934, 9 clinicians

Practice addresses (Care Compare)

418 N Utica
Lubbock, TX 79416-3035
Phone (806) 771-5882

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock Urology Clinic, LLP Urology CurrentSince Jan 1, 2015 Accepting new patients
Jorge R Brothers M D P a PastSince Jan 1, 2015 Accepting new patients
Meridian LTC LTD PastSince Aug 10, 2010 Accepting new patients

Locations

3502 82nd St
Lubbock, TX 79423
Phone (806) 788-1844

418 N Utica Ave
Lubbock, TX 79416
Phone (806) 771-5882

6102 82nd St
Ste 5
Lubbock, TX 79424
Phone (806) 771-0077

Interoperability endpoints

  • Direct secure messaging: sspore@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Ralls Nursing HomeRalls, TX, CCN 675407 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Dec 1, 2014
Dec 13, 2024
Jan 23, 2025
Apex Secure Care BrownfieldBrownfield, TX, CCN 675019 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Dec 1, 2023
Dec 1, 2014
Jan 23, 2025
Clarendon Nursing HomeClarendon, TX, CCN 676411 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (49.5%)
Limited Partnership Interest (49.5%)
Corporate Director (33%)
W-2 Managing Employee
Indirect Ownership Interest		 Mar 1, 2016
Mar 1, 2016
Mar 1, 2016
Mar 1, 2016
Mar 1, 2016

Owned or controlled facilities with NPI records 3

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

  • Childress County Hospital District

    dba Apex Secure Care Brownfield

    • Skilled Nursing Facility
    • Brownfield, TX
    • NPI 1013312248

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Childress County Hospital District

    dba Ralls Nursing Home

    • Skilled Nursing Facility
    • Ralls, TX
    • NPI 1578968707

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Clarendon NH Operations

    dba Clarendon Nursing Home

    • Skilled Nursing Facility
    • Clarendon, TX
    • NPI 1447619663

    5% Or Greater Indirect Ownership Interest, Corporate Director, Indirect Ownership Interest, Limited Partnership Interest, W-2 Managing Employee

    CMS ownership

Organizations & group practices 3

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 9

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1447334867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N UTICA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163035",
            "telephone_number": "806-771-5882",
            "fax_number": "806-687-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N UTICA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163035",
            "telephone_number": "806-771-5882",
            "fax_number": "806-687-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORE",
        "first_name": "SCOTT",
        "middle_name": "STEVEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "K2124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134316208",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8F5901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "124581101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.