Active NPI
James Raymond Spenningsby, MD
- Ophthalmology Physician
- Grand Rapids, MN
National Provider Identifier
1669460267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 21647
- Practice address
- 1542 Golf Course Rd
Suite 201
Grand Rapids, MN 55744-3555 - Phone
- (218) 326-3433
- Fax
- (218) 326-3435
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 21647 | MN | Primary |
Addresses
Primary practice location
1542 Golf Course Rd
Suite 201
Grand Rapids, MN 55744-3555
Mailing address
1542 Golf Course Rd
Suite 201
Grand Rapids, MN 55744-3555
Phone (218) 326-3433
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008-0002634 | Other | MN | MEDICA GRAND RAPIDS |
| 0817780 | Other | MEDICA | |
| 180006396 | Other | TRAVELERS MC | |
| 0E085 | Other | BLUE SHIELD OF MN | |
| 16523 | Other | ND | MEDICAL ASSISTANCE |
| 1669460267 | Other | MN | BCBS MN NPI |
| 0008-0002636 | Other | MN | MEDICA HIBBING |
| 1669460267 | Other | MN | PREFERRED ONE |
| 180001615 | Other | MN | PTAN |
| 19012SP | Other | BLUE SHIELD OF MN | |
| 23230 | Other | ND | NORIDIAN |
| 29972 | Other | HEALTH PARTNERS | |
| 1989 | Other | MN | NORIDIAN |
| 432793400 | Medicaid | MN | |
| 986521006415 | Other | PREFERRED ONE | |
| 1669460267 | Other | MN | HEALTHPARTNERS |
| 1669460267 | Other | MN | UCARE |
| HP50071 | Other | HEALTH PARTNERS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377561600000",
"number": "1669460267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1542 GOLF COURSE RD",
"address_2": "SUITE 201",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557443555",
"telephone_number": "218-326-3433",
"fax_number": "218-326-3435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1542 GOLF COURSE RD",
"address_2": "SUITE 201",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557443555",
"telephone_number": "218-326-3433",
"fax_number": "218-326-3435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENNINGSBY",
"first_name": "JAMES",
"middle_name": "RAYMOND",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2013-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MN",
"license": "21647",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA GRAND RAPIDS",
"identifier": "0008-0002634",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0817780",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS MC",
"identifier": "180006396",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF MN",
"identifier": "0E085",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "16523",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN NPI",
"identifier": "1669460267",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HIBBING",
"identifier": "0008-0002636",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1669460267",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "180001615",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF MN",
"identifier": "19012SP",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORIDIAN",
"identifier": "23230",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "29972",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORIDIAN",
"identifier": "1989",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "432793400",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "986521006415",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "1669460267",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "1669460267",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP50071",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.