Scarlet Rae Spain, MSN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28160228A Issued in IN

Practice address

3210 Watling St
Medical Dept. 8-210
East Chicago, IN 46312-1716

Phone

(219) 399-3133

Fax

(219) 399-5814

NPI assigned

Dec 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1891024261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 WATLING ST",
            "address_2": "MEDICAL DEPT. 8-210",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463121716",
            "telephone_number": "219-399-3133",
            "fax_number": "219-399-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 WATLING ST",
            "address_2": "MEDICAL DEPT. 8-210",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463121716",
            "telephone_number": "219-399-3133",
            "fax_number": "219-399-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAIN",
        "first_name": "SCARLET",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28160228A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.