Individual provider Active NPI

Emily Holcomb Spires, CPT

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1669940052
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9117238 Issued in FL
Practice address
2018 Western Ave
Knoxville, TN 37921-5718
Phone
(865) 544-0406
Fax
(865) 544-0480
NPI assigned
Nov 5, 2018
Reactivated
Jul 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X
Physician Assistant 363A00000X 9117238 FL Primary

Addresses

Primary practice location

2018 Western Ave
Knoxville, TN 37921-5718

Mailing address

911 Shalimar Point Dr
Shalimar, FL 32579-1653
Phone (865) 209-4987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924004747 TX Practitioner - Physician Assistant 4486195997 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9117238FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Doctors Express of the Temple Area, PA Past Accepting new patients

Locations

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Interoperability endpoints

  • Direct secure messaging: emily.spires.1@15074.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1669940052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 SHALIMAR POINT DR",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791653",
            "telephone_number": "865-209-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 WESTERN AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379215718",
            "telephone_number": "865-544-0406",
            "fax_number": "865-544-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIRES",
        "first_name": "EMILY",
        "middle_name": "HOLCOMB",
        "credential": "CPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "deactivation_date": "2023-07-11",
        "reactivation_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9117238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.