Angela J Spray, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2004004910 Issued in MO

Practice address

7136 S Outer Road 364
O Fallon, MO 63368-7756

Phone

(636) 561-3277

Fax

(636) 561-5280

NPI assigned

Jun 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Specialty

Dermatology

Education

Saint Louis University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

O'Fallon Dermatology Specialists, P.C.Group PAC ID 8729043948, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• O'Fallon Dermatology Specialists, P.C.

  • Specialist
  • O'Fallon, MO
  • NPI 1255468906
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1477599884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7136 S OUTER ROAD 364",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687756",
            "telephone_number": "636-561-3277",
            "fax_number": "636-561-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7136 S OUTER ROAD 364",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687756",
            "telephone_number": "636-561-3277",
            "fax_number": "636-561-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAY",
        "first_name": "ANGELA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2004004910",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MO",
            "license": "2004004910",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "MO",
            "license": "2004004910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spectrum Monitoring, LLC
• Speech Works
• Dawn Spell, FNP-C
• Teri Jo Spencer, MS/CCC-SLP
• Sports and Family Chiropractic
• Hannah Spray, PA-C
• Springer Physical Therapy LLC
• Springer Physical Therapy LLC
• SSM Health Care St. Louis (SSM Health Prescription Center)
• SSM Medical Group Inc. (SSM Health Medical Group)

• Dermatology Physician in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.