NPIMap

Individual provider Active NPI

Joshua Michael Spore, DO

  • Family Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1710563259
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-16228 Issued in AR
Practice address
1125 N College Ave
Fayetteville, AR 72703-1908
Phone
(479) 521-8260
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
Yes

Organizations & group practices 11

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.

Hospital & facility affiliations 3

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springdale Bentonville HBP Services LLC 88 clinicians

Practice addresses (Care Compare)

3000 Medical Ctr Pkwy
Bentonville, AR 72712-3217
Phone (479) 553-1000

Hospital & facility affiliations

  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022
  • Siloam Springs Regional Hospital Hospital, Siloam Springs, AR, CCN 040001
  • Northwest Medical Center Inpatient Rehab Inpatient rehabilitation facility, Springdale, AR, CCN 04T022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230919003329 AR Practitioner - Family Practice 6709240021 Reassigns benefits to 7 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ies HSP Arkansas PLLC Hospitalist CurrentSince Jul 1, 2023 Accepting new patients
Springdale- Bentonville HBP Services, LLC Hospitalist CurrentSince May 3, 2024 Accepting new patients
Crawford Physician Services, PLLC Hospitalist CurrentSince Oct 1, 2024 Accepting new patients
Conway Regional Medical Center, Inc. Hospitalist CurrentSince Mar 1, 2024 Accepting new patients
Sebastian Physician Services, PLLC Hospitalist CurrentSince Oct 1, 2024 Accepting new patients
Conway Regional Medical Center Inc Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
Arkansas Post Discharge Services, PLLC Hospitalist CurrentSince Oct 1, 2024 Accepting new patients
Prime Physicians LLC Hospitalist CurrentSince Jul 1, 2023 Accepting new patients
Baptist Health Regional Hospitals Past Accepting new patients
Siloam Springs Arkansas Hospital Company LLC Past Accepting new patients
Northwest Arkansas Hospitals, LLC Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

1100 E Poplar St
Clarksville, AR 72830
Phone (479) 754-5393

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300

200 Corporate Blvd
Lafayette, LA 70508

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X E-16228 AR
Family Medicine Physician 207Q00000X E-16228 AR Primary

Addresses

NPPES NPI Registry

Primary practice location

1125 N College Ave
Fayetteville, AR 72703-1908

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 29, 2024.

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1710563259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031908",
            "telephone_number": "479-521-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORE",
        "first_name": "JOSHUA",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-16228",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-16228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.