Dr Laurence W Spivack DPM Inc

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36001535 Issued in OH

Legal business name

DR LAURENCE W SPIVACK DPM INC

Practice address

9330 Hidden Glen Dr
Mentor, OH 44060

Phone

(440) 487-3947

Fax

(513) 858-7827

NPI assigned

Jun 19, 2018

Organization subpart

No

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

Authorized official

Name

Laurence Spivack, DPM

Title

DPM/Owner

Phone

(440) 487-3947

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerome M Privitera, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mentor, OH
  • NPI 1639173628
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1801380241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 HIDDEN GLEN DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607362",
            "telephone_number": "440-487-3947",
            "fax_number": "513-858-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 HIDDEN GLEN DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44060",
            "telephone_number": "440-487-3947",
            "fax_number": "513-858-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR LAURENCE W SPIVACK DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "SPIVACK",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_title_or_position": "DPM/OWNER",
        "authorized_official_telephone_number": "440-487-3947",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36001535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Mentor, OH
• Providers in Mentor, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.