Individual provider Active NPI

Anthony David Spadoni, PA-C

  • Physician Assistant
  • Joint Base Lewis McChord, WA
National Provider Identifier
1790413896
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9040A Jackson Ave
Joint Base Lewis McChord, WA 98431-7394
Phone
(253) 968-1110
Fax
(253) 968-3203
NPI assigned
Aug 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

9040A Jackson Ave
Joint Base Lewis McChord, WA 98431-7394

Mailing address

6040A Jackson Ave
Joint Base Lewis McChord, WA 98431-0001
Phone (253) 968-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1790413896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040A JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1110",
            "fax_number": "523-968-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040A JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984317394",
            "telephone_number": "253-968-1110",
            "fax_number": "253-968-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADONI",
        "first_name": "ANTHONY",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joint Base Lewis McChord, WA

Sources for this page

Verify at the official NPI Registry.