Individual provider Active NPI

Wendy Leigh Spanos, M.D.

  • Family Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1629037585
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C7731 Issued in AR
Practice address
1107 E Matthews Ave
Suite 103
Jonesboro, AR 72401-4315
Phone
(870) 935-0700
Fax
(870) 935-0706
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C7731 AR Primary

Addresses

Primary practice location

1107 E Matthews Ave
Suite 103
Jonesboro, AR 72401-4315

Mailing address

1107 E Matthews Ave
Suite 103
Jonesboro, AR 72401-4315
Phone (870) 935-0700

Other identifiers 1

IdentifierTypeStateIssuer
124127001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20070502000584 AR Practitioner - General Practice 7517063894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Arkansas College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1107 E Matthews Ave
Suite 103
Jonesboro, AR 72401-4331
Phone (870) 935-0700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy Spanos, M.D., P.a. CurrentSince Jun 1, 2006 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1107 E Matthews Ave
Ste 103
Jonesboro, AR 72401
Phone (870) 935-0700

201 Highway 463 N
Trumann, AR 72472
Phone (870) 483-1075

Interoperability endpoints

  • Direct secure messaging: wendy.spanos.1@29042.direct.athenahealth.com

Organizations & group practices 2

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1629037585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E MATTHEWS AVE",
            "address_2": "SUITE 103",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014315",
            "telephone_number": "870-935-0700",
            "fax_number": "870-935-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 E MATTHEWS AVE",
            "address_2": "SUITE 103",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014315",
            "telephone_number": "870-935-0700",
            "fax_number": "870-935-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANOS",
        "first_name": "WENDY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C7731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124127001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.