Individual provider Active NPI

Jeffrey M Spear, M.D.

  • Emergency Medicine Physician
  • Poteau, OK
National Provider Identifier
1477528776
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
15000 Issued in OK
Practice address
105 Wall St
Poteau, OK 74953-4433
Phone
(918) 635-3400
Fax
(918) 635-3394
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 15000 OK Primary
Emergency Medicine Physician 207P00000X R-4340 AR

Addresses

Primary practice location

105 Wall St
Poteau, OK 74953-4433

Mailing address

34001 Berryfrost LN
Poteau, OK 74953-9003
Phone (918) 647-0660

Other identifiers 1

IdentifierTypeStateIssuer
100229820BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141114001456 TX Practitioner - Emergency Medicine 0042100133 Reassigns benefits to 1 organization
I20141211000153 AR Practitioner - Emergency Medicine 0042100133 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Johns Hopkins University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springdale Bentonville HBP Services LLCGroup PAC ID 1052759263, 88 clinicians

Practice addresses (Care Compare)

3000 Medical Ctr Pkwy
Bentonville, AR 72712-3217
Phone (479) 553-1000

Hospital & facility affiliations

  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R-4340ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Arkansas Emergency Physicians LLP Emergency Medicine CurrentSince Oct 1, 2015 Accepting new patients
Southeast Arkansas Emergency Physicians LLP Emergency Medicine CurrentSince Oct 1, 2015 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince May 1, 2020 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince May 6, 2020 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince May 1, 2020 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Oct 17, 2014 Accepting new patients
Springdale- Bentonville HBP Services, LLC Emergency Medicine CurrentSince Nov 17, 2024 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Oct 17, 2014 Accepting new patients
South Arkansas Emergency Physicians LLP Emergency Medicine Current Accepting new patients
Van Buren Hma Inc Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

1255 S Shiloh Dr
Fayetteville, AR 72701
Phone (479) 757-1760

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1477528776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34001 BERRYFROST LN",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749539003",
            "telephone_number": "918-647-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WALL ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534433",
            "telephone_number": "918-635-3400",
            "fax_number": "918-635-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAR",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "15000",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "R-4340",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100229820B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

Verify at the official NPI Registry.