NPIMap

Organization Active NPI

Spectrum Medical Inc

  • Orthopaedic Surgery Physician
  • Danville, VA
National Provider Identifier
1861597072
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0128376 1 Issued in VA
Legal business name
SPECTRUM MEDICAL INC
Practice address
109 Bridge St Ste 300
Danville, VA 24541-1222
Phone
(434) 793-4711
Fax
(434) 797-2514
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
Dr. Mark C Hermann, MDNPI 1740249416
Title
Physician
Phone
(434) 793-4711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 0128376 1 VA
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X 0128376 1 VA
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 0128376 1 VA Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X 0128376 1 VA
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X VA
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 0128376 1 VA

Addresses

Primary practice location

109 Bridge St Ste 300
Danville, VA 24541-1222

Mailing address

109 Bridge St Ste 300
Danville, VA 24541-1222
Phone (434) 793-4711

Other identifiers 2

IdentifierTypeStateIssuer
8901398MedicaidNC
034487OtherVAANTHEM BC OF VA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.spectrummed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000282 VA Part B Supplier - Clinic/Group Practice 5193624617 Receives reassigned benefits from 22 practitioners
Practice locations: Danville, VA

National Provider Directory

National Provider Directory

Locations

1075 Spruce St
Martinsville, VA 24112
Phone (276) 790-3233

Interoperability endpoints

  • Direct secure messaging: markhermann@spectrummed.allscriptsdirect.net
  • Direct secure messaging: jamesdailey@spectrummed.allscriptsdirect.net
  • Direct secure messaging: johnmahoney@spectrummed.allscriptsdirect.net
  • Direct secure messaging: stuartkramer@spectrummed.allscriptsdirect.net
  • Direct secure messaging: kurtvoos@spectrummed.allscriptsdirect.net
  • Direct secure messaging: sharukhshroff@spectrummed.allscriptsdirect.net
  • Direct secure messaging: josephcampbell@spectrummed.allscriptsdirect.net
  • Direct secure messaging: susannewashburn@spectrummed.allscriptsdirect.net
  • Direct secure messaging: eugenejackson@spectrummed.allscriptsdirect.net
  • Direct secure messaging: ramonrubertethiele@spectrummed.allscriptsdirect.net
  • Direct secure messaging: stephanjannach@spectrummed.allscriptsdirect.net
  • Direct secure messaging: jonathankrome@spectrummed.allscriptsdirect.net
  • Direct secure messaging: stephenernst@spectrummed.allscriptsdirect.net
  • Direct secure messaging: eduardofraifeld@spectrummed.allscriptsdirect.net
  • Direct secure messaging: jamestreadwell@spectrummed.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1861597072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BRIDGE ST STE 300",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411222",
            "telephone_number": "434-793-4711",
            "fax_number": "434-797-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BRIDGE ST STE 300",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411222",
            "telephone_number": "434-793-4711",
            "fax_number": "434-797-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "HERMANN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "434-793-4711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0128376 1",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0128376 1",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0128376 1",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "VA",
            "license": "0128376 1",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0128376 1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901398",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC OF VA",
            "identifier": "034487",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.spectrummed.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "109 Bridge St Ste 300",
            "city": "Danville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245411222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.