Spirit Soaring Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SPIRIT SOARING MEDICAL PLLC

Practice address

2761 Johnson Hill Rd
Swain, NY 14884-9707

Phone

(607) 564-8011

NPI assigned

Feb 24, 2020

Last updated

Feb 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Tallman

Title

Owner

Phone

(607) 564-8011

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1639703192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2761 JOHNSON HILL RD",
            "city": "SWAIN",
            "state": "NY",
            "postal_code": "148849707",
            "telephone_number": "607-564-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2761 JOHNSON HILL RD",
            "city": "SWAIN",
            "state": "NY",
            "postal_code": "148849707",
            "telephone_number": "607-564-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT SOARING MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "TALLMAN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-564-8011"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Dieter, RN
• Brecken F Jones, RN

• Family Medicine Physician in Swain, NY
• Providers in Swain, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.