Active NPI
Nancy Walls Van Speybroeck, MD
- Rheumatology Physician
- Eureka, CA
National Provider Identifier
1720184393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- G28255
- Practice address
- 2280 Harrison Ave
Suite B
Eureka, CA 95501-3200 - Phone
- (707) 443-9371
- NPI assigned
- Sep 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | G28255 | CA | Primary |
Addresses
Primary practice location
2280 Harrison Ave
Suite B
Eureka, CA 95501-3200
Mailing address
2280 Harrison Ave
Suite B
Eureka, CA 95501-3200
Phone (707) 443-9371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G282550 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G28255 | CA | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277164800000",
"number": "1720184393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2280 HARRISON AVE",
"address_2": "SUITE B",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013200",
"telephone_number": "707-443-9371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2280 HARRISON AVE",
"address_2": "SUITE B",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013200",
"telephone_number": "707-443-9371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN SPEYBROECK",
"first_name": "NANCY",
"middle_name": "WALLS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2010-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "CA",
"license": "G28255",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G282550",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.