Active NPI
Lawrence D Spivack, M.D.
- Ophthalmology Physician
- Centennial, CO
National Provider Identifier
1730144932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 21083
- Practice address
- 6881 S Yosemite St
Centennial, CO 80112-1406 - Phone
- (303) 740-9310
- Fax
- (303) 740-5494
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 21083 | CO | Primary |
Addresses
Primary practice location
6881 S Yosemite St
Centennial, CO 80112-1406
Mailing address
6881 S Yosemite St
Centennial, CO 80112-1406
Phone (303) 740-9310
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21083 | CO | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189382400000",
"number": "1730144932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6881 S YOSEMITE ST",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801121406",
"telephone_number": "303-740-9310",
"fax_number": "303-740-5494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6881 S YOSEMITE ST",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801121406",
"telephone_number": "303-740-9310",
"fax_number": "303-740-5494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIVACK",
"first_name": "LAWRENCE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2007-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CO",
"license": "21083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.