Active NPI
Deontrae Spruill
- Private Vehicle
- Elizabeth City, NC
National Provider Identifier
1538601323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- Practice address
- 1033 Shannon St
Elizabeth City, NC 27909-6063 - Phone
- (816) 489-2299
- NPI assigned
- Nov 9, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | NC | ||
| Taxi | 344600000X | NC | ||
| Private Vehicle | 347C00000X | NC | Primary |
Addresses
Primary practice location
1033 Shannon St
Elizabeth City, NC 27909-6063
Mailing address
1033 Shannon St
Elizabeth City, NC 27909-6063
Phone (816) 489-2299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cosmiccare | Non-Emergency Medical Transport (Van) | Past | Accepting new patients |
Organizations & group practices 1
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": "1478649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479254400000",
"number": "1538601323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 SHANNON ST",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279096063",
"telephone_number": "816-489-2299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 SHANNON ST",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279096063",
"telephone_number": "816-489-2299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRUILL",
"first_name": "DEONTRAE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-09",
"last_updated": "2016-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "344600000X",
"taxonomy_group": "",
"desc": "Taxi",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth City, NC
- Angela Jean Speck, M.ED, ED.S.
- Waynette Twiford Speight, RN,BSN,CDE
- Nakesha Danielle Spellman
- /Deborah Burnett Spence, MA, LPC
- Trista Taelor Spencer
- Jason R Spruill, OCCUPATIONAL THERAP
- Joseph Milton Spruill Jr., M.D.
- Nashauna Jackson Stallings, MSW, LCSWA, LCASA
- Wanda Stallings
- Meagan Stalter, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.