Organization Active NPI

Spradling Medical & Treatment LLC

  • Family Medicine Physician
  • Hurricane, WV
National Provider Identifier
1902580780
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SPRADLING MEDICAL & TREATMENT LLC
Practice address
3536 Teays Valley Rd
Hurricane, WV 25526-9054
Phone
(304) 962-1008
NPI assigned
Jun 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Lisa SpradlingNPI 1710516034
Title
FNP/ Medical Director
Phone
(304) 962-1008

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Genetics Clinic/Center 261QG0250X

Addresses

Primary practice location

3536 Teays Valley Rd
Hurricane, WV 25526-9054

Mailing address

3536 Teays Valley Rd
Hurricane, WV 25526-9054
Phone (304) 962-1008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230920000238 WV Part B Supplier - Clinic/Group Practice 0244694529 Receives reassigned benefits from 1 practitioner
Practice locations: Hurricane, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2288670Spradling Medical & Treatment3536 Teays Valley Rd, Hurricane, WV 25526Certificate of waiverAug 28, 2027

National Provider Directory

National Provider Directory

Locations

40 Shae Ave
#A
Chapmanville, WV 25508
Phone (304) 310-2261

3536 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 223-5200

104 Main St
Logan, WV 25601
Phone (304) 688-7027

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1902580780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269054",
            "telephone_number": "304-962-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269054",
            "telephone_number": "304-962-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRADLING MEDICAL & TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-13",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "SPRADLING",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "FNP/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "304-962-1008"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.