John M Speca, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

23479 Issued in MS

Practice address

785 Ohio Ave Ste 1H
Clarksdale, MS 38614-6213

Phone

(662) 621-2438

Fax

(662) 621-2469

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nwmjspeca@yourcarecommunity.org

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.

• Delta Medical Group

  • Emergency Medicine Physician
  • Greenville, MS
  • NPI 1790701134

  Orthopaedic Surgery

  Medicare reassignment NPD
• Northwest Miss Regional Medical Center

  • Internal Medicine Physician
  • Clarksdale, MS
  • NPI 1598458515

  Orthopaedic Surgery

  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Delta Health System

  • Internal Medicine Physician
  • Clarksdale, MS
  • NPI 1609464619

  Orthopaedic Surgery

  NPD
• Northwest Miss Regional Medical Center

  • Emergency Medicine Physician
  • Clarksdale, MS
  • NPI 1699468686
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• State of Mississippi-University of Mississippi Medical Center

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1932538527
  NPD
• Clarksdale Hma Physician Management LLC

  • Internal Medicine Physician
  • Clarksdale, MS
  • NPI 1740297688

  Orthopaedic Surgery

  NPD (past)
• Delta Physician Practices

  • Family Nurse Practitioner
  • Greenville, MS
  • NPI 1598086639
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Peak Orthopaedic & Sports Caresc

  • Orthopaedic Surgery Physician
  • Streator, IL
  • NPI 1114106242
  NPD (past)
• St Marys Hospital

  • Orthopaedic Surgery Physician
  • Streator, IL
  • NPI 1164673307
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1659330090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE STE 1H",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146213",
            "telephone_number": "662-621-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE STE 1H",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146213",
            "telephone_number": "662-621-2438",
            "fax_number": "662-621-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECA",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-070970",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "47677",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "23479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01676197",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070970",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08870040",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.speca.1@4695.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "785 Ohio Ave Ste 1H",
            "city": "Clarksdale",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386146213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marian Smith, FNP
• Quinton Smith, M.ED.
• Sherrica Sherrell Smith, FNP-C, PMHNP-BC
• Val Soldevila, RPH, CFO
• Michael Kevin Spears, OT
• Lakeia Shonte Starks, MSW
• Whitney Jean Marie Starks
• Kelcey S Steinriede, M.ED.
• Jushunta Yuvoni Stephens
• Tiffany Smith Stewart, M.ED.

• Orthopaedic Surgery Physician in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Orthopaedic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.