Individual provider Active NPI

Scott David Spillan, NP-C

  • Adult Health Nurse Practitioner
  • Akron, OH
National Provider Identifier
1710118500
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
10828-NP Issued in OH
Practice address
75 Arch St
G2
Akron, OH 44304-1429
Phone
(330) 375-4100
Fax
(330) 375-4097
NPI assigned
Jul 28, 2009
Last updated
Jan 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 10828-NP OH Primary

Addresses

Primary practice location

75 Arch St
G2
Akron, OH 44304-1429

Mailing address

525 E Market St
PO Box 2090
Akron, OH 44304-1619
Phone (330) 996-0347

Other identifiers 2

IdentifierTypeStateIssuer
3016033MedicaidOH
NP31332OtherOHMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090817000308 OH Practitioner - Nurse Practitioner 3870647456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

161 N Forge St
Akron, OH 44304-1483

525 E Market St
Akron, OH 44304-1619

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10828-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC CurrentSince Mar 13, 2011 Accepting new patients
Summa Physicians LLC CurrentSince Mar 13, 2011 Accepting new patients
Summa Physicians LLC Past Accepting new patients

Locations

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

75 Arch St
Ste G2
Akron, OH 44304
Phone (330) 375-3039

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1710118500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "address_2": "PO BOX 2090",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619",
            "telephone_number": "330-996-0347",
            "fax_number": "330-996-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ARCH ST",
            "address_2": "G2",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041429",
            "telephone_number": "330-375-4100",
            "fax_number": "330-375-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPILLAN",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "10828-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016033",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "NP31332",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.