Spencer Ray Stiles

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

3815 Issued in WV

Practice address

9000 Coombs Farm Rd
Suite 304
Morgantown, WV 26508-1149

Phone

(304) 282-7898

NPI assigned

Jul 9, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Professional Dental Alliance Specialty 2

  • Endodontics
  • Uniontown, PA
  • NPI 1508358425
  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1922261908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD",
            "address_2": "SUITE 304",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081149",
            "telephone_number": "304-282-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD",
            "address_2": "SUITE 304",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081149",
            "telephone_number": "304-282-7898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 River Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215024629",
            "country_code": "US",
            "telephone_number": "240-362-7017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Mary Higginson Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "PA",
            "postal_code": "154012657",
            "country_code": "US",
            "telephone_number": "724-438-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILES",
        "first_name": "SPENCER",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "15197",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS037625",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WV",
            "license": "3815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shuridan Stewart
• Staci K Stewart, M.D.
• Tiernie Brianne Stewart, OTRL
• Colin Stickles
• Sarah Elizabeth Stiles, APRN, FNP-C
• John Stilgenbauer, PHARM D
• Seth Stilgenbauer
• Vincent Gerard Stilger, HSD, ATC
• Stillwater LLC
• Katherine Stillwell, PTA

• Endodontics in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Endodontics in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.