NPIMap

Organization Active NPI

Spearman MD Inc.

Doing business as Central Coast Vein& Vascular

  • Vascular & Interventional Radiology Physician
  • Pismo Beach, CA
National Provider Identifier
1508249202
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
SPEARMAN MD INC.
Doing business as
Central Coast Vein& Vascular
Practice address
901 Oak Park Blvd Ste 103
Pismo Beach, CA 93449-3409
Phone
(805) 888-4744
Fax
(805) 825-3789
NPI assigned
Jun 30, 2015
Last updated
Apr 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Mr. Kenneth Spearman, MDNPI 1912107772
Title
President
Phone
(805) 473-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X CA Primary

Addresses

Primary practice location

901 Oak Park Blvd Ste 103
Pismo Beach, CA 93449-3409

Mailing address

880 Oak Park Blvd
Suite 201
Arroyo Grande, CA 93420-1821
Phone (805) 473-8346

Other practice location 1

880 Oak Park Blvd
Suite 201
Arroyo Grande, CA 93420-1821
Phone (805) 473-8346

Other names 1

  • Central Coast Vein& Vascular Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151013002286 CA Part B Supplier - Clinic/Group Practice 1456660455 Receives reassigned benefits from 3 practitioners
Practice locations: Arroyo Grande, CA; Pismo Beach, CA
O20230207000826 CA DME Supplier - Physician - General Practice 1456660455 Practice locations: Pismo Beach, CA

National Provider Directory

National Provider Directory

Locations

880 Oak Park Blvd
Arroyo Grande, CA 93420
Phone (805) 473-8346

880 Oak Park Blvd
Ste 201
Arroyo Grande, CA 93420
Phone (805) 473-8346

901 Oak Park Blvd
Ste 102103
Pismo Beach, CA 93449

100 Colony Rd
San Luis Obispo, CA 93409
Phone (805) 547-7807

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1508249202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 OAK PARK BLVD",
            "address_2": "SUITE 201",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201821",
            "telephone_number": "805-473-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD STE 103",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493409",
            "telephone_number": "805-888-4744",
            "fax_number": "805-825-3789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 Oak Park Blvd",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934201821",
            "country_code": "US",
            "telephone_number": "805-473-8346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPEARMAN MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "SPEARMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-473-8346",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Coast Vein& Vascular",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Coast Vein& Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pismo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.