NPIMap

Individual provider Active NPI

William David Speer, PA-C

  • Physician Assistant
  • Middleburg, FL
National Provider Identifier
1578803573
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
430 College Dr
Suite 104-106
Middleburg, FL 32068-8530
Phone
(904) 298-1994
Fax
(904) 298-1973
NPI assigned
Feb 27, 2013
Last updated
Jun 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

430 College Dr
Suite 104-106
Middleburg, FL 32068-8530

Mailing address

430 College Dr
Suite 104-106
Middleburg, FL 32068-8530
Phone (904) 298-1994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150213000366 FL Practitioner - Physician Assistant 6002131133 Reassigns benefits to 6 organizations
I20260331002477 AL Practitioner - Physician Assistant 6002131133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

117 Harper LN
Madison, AL 35756-6707

PO Box
Suite 242848
Montgomery, AL 36124

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Orthopedic Specialists, LLC Past Accepting new patients
Solantic of Jacksonville, LLC PastSince Sep 5, 2021 Accepting new patients

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1578803573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 COLLEGE DR",
            "address_2": "SUITE 104-106",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688530",
            "telephone_number": "904-298-1994",
            "fax_number": "904-298-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 COLLEGE DR",
            "address_2": "SUITE 104-106",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688530",
            "telephone_number": "904-298-1994",
            "fax_number": "904-298-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEER",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

Verify at the official NPI Registry.