Individual provider Active NPI

Laura Elizabeth Spahr, DO

  • Pediatrics Physician
  • Bloomsburg, PA
National Provider Identifier
1689635179
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS009944L Issued in PA
Practice address
425 East First St
Ste. 201
Bloomsburg, PA 17815-6080
Phone
(570) 416-1816
NPI assigned
Apr 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 44727 WI
Pediatrics Physician 208000000X OS009944L PA Primary

Addresses

Primary practice location

425 East First St
Ste. 201
Bloomsburg, PA 17815-6080

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

603 Washington Rd
Suite 300
MT Lebanon, PA 15228-1909
Phone (412) 563-6151

Other identifiers 1

IdentifierTypeStateIssuer
43500200MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lspahr151238@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20171017000947 PA Practitioner - Pediatric Medicine 8921374190 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS009944LPAMDPediatrics Physician
44727WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Pediatrics CurrentSince Oct 2, 2017 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Oct 2, 2017 Accepting new patients
Geisinger Clinic Past Accepting new patients
Children'S Community Care Pediatrics Past Accepting new patients
Childrens Community Pediatrics Pediatrics Past Accepting new patients

Locations

2407 Reichart Rd
Bloomsburg, PA 17815
Phone (570) 784-6320

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

425 E 1st St
Ste 201
Bloomsburg, PA 17815
Phone (570) 387-2280

100 N Academy Ave
Danville, PA 17822

119 Nevada Dr
Kulpmont, PA 17834
Phone (570) 373-1250

Organizations & group practices 6

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": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1689635179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 EAST FIRST ST",
            "address_2": "STE. 201",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178156080",
            "telephone_number": "570-416-1816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 Washington Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "MT Lebanon",
            "state": "PA",
            "postal_code": "152281909",
            "country_code": "US",
            "telephone_number": "412-563-6151",
            "fax_number": "412-344-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAHR",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-01",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "44727",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS009944L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43500200",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lspahr151238@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "425 East First St",
            "address_2": "Ste. 201",
            "city": "Bloomsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178156080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.