Individual provider Active NPI

Dustin Spillman, AU.D.

  • Audiologist
  • Kalispell, MT
National Provider Identifier
1700258019
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5221 Issued in MT
Practice address
160 Heritage Way
Ste 201
Kalispell, MT 59901-3161
Phone
(406) 752-1014
Fax
(406) 756-1379
NPI assigned
Oct 26, 2015
Sex
Male
Sole proprietor
Yes

Organizations & group practices 4

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.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013000820 WA Practitioner - Qualified Audiologist 6305156613 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5221MTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiologists Northwest, Inc. Audiologist CurrentSince Jun 1, 2017 Accepting new patients
Audiologists Northwest PastSince Aug 4, 2017 Accepting new patients
Logan Health - Whitefish Past Accepting new patients
Harbor Audiology & Hearing Services Inc Audiologist Past Accepting new patients

Locations

1411 Wheaton Way
Bremerton, WA 98310
Phone (360) 479-4065

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 5221 MT
Hearing Instrument Specialist 237700000X 5221 MT
Audiologist 231H00000X 5221 MT Primary
Hearing Aid Equipment 332S00000X 5221 MT

Addresses

NPPES NPI Registry

Primary practice location

160 Heritage Way
Ste 201
Kalispell, MT 59901-3161

Mailing address

160 Heritage Way
Ste 201
Kalispell, MT 59901-3161
Phone (406) 752-1014

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 23, 2016.

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1700258019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY",
            "address_2": "STE 201",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013161",
            "telephone_number": "406-752-1014",
            "fax_number": "406-756-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY",
            "address_2": "STE 201",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013161",
            "telephone_number": "406-752-1014",
            "fax_number": "406-756-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPILLMAN",
        "first_name": "DUSTIN",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MT",
            "license": "5221",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MT",
            "license": "5221",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MT",
            "license": "5221",
            "primary": true
        },
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "MT",
            "license": "5221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.