Jessica Spaeth, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4542 Issued in NC

Practice address

2601 Iron Gate Dr Ste 101
Wilmington, NC 28412-6624

Phone

(910) 202-9113

NPI assigned

Nov 18, 2013

Last updated

Oct 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.spaeth@karen-kirk.direct.kno2fy.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Psychiatry Physician
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  • NPI 1184737462

  Psychologist

  Medicare reassignment NPD
• Karen S. Kirk, PHD, PLLC

  dba Cape Fear Developmental Therapies PLLC

  • Clinical Psychologist
  • Wilmington, NC
  • NPI 1588912513
  NPD

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1689004350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 IRON GATE DR STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126624",
            "telephone_number": "910-202-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 IRON GATE DR STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126624",
            "telephone_number": "910-202-9113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2460 Delaney Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036062",
            "country_code": "US",
            "telephone_number": "910-202-9113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAETH",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sovereign Solutions Logistics
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• Kristina Spackman, M. S.
• Zoe Spadaro, OTR/L
• Kim M Spader, P-LCSW
• Leta Olivia Spain
• Jessica May Spanton, RBT ASSISTANT
• Bryan Thomas Sparks, PHARMD
• SPC Home Health LLC (SPC Home Care)
• SPC Home Health LLC (SPC Home Care)

• Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.