Individual provider Active NPI

John Edward Spaulding Jr., M.D.

  • Emergency Medicine Physician
  • Emeryville, CA
National Provider Identifier
1912918897
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
42448 Issued in GA
Practice address
2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone
(510) 350-2600
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 42448 GA Primary

Addresses

Primary practice location

2100 Powell St
Suite 900
Emeryville, CA 94608-1826

Mailing address

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (404) 501-1849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816000876 GA Practitioner - Emergency Medicine 1850284548 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42448GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients
Emerginet SRMC, LLC Past Accepting new patients
Floyd Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Mesa Emergency Group LLC Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912918897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "404-501-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAULDING",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "42448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.