Individual provider Active NPI

Tina Spence, P.A.-C

  • Physician Assistant
  • Weston, WV
National Provider Identifier
1922547207
Registry record updated Mar 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2043 Issued in WV
Practice address
936 Sharpe Hospital Rd
Weston, WV 26452-8550
Phone
(304) 269-1210
NPI assigned
Feb 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2043 WV Primary

Addresses

Primary practice location

936 Sharpe Hospital Rd
Weston, WV 26452-8550

Mailing address

936 Sharpe Hospital Rd
Weston, WV 26452-8550
Phone (304) 269-1210

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190107003383 WV Practitioner - Physician Assistant 6204172570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William R Sharpe Jr HospitalGroup PAC ID 8224949383, 19 clinicians

Practice addresses (Care Compare)

936 Sharpe Hospital Rd
Weston, WV 26452-8550
Phone (304) 269-1210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
William R Sharpe Jr Hospital CurrentSince Jan 26, 2021 Accepting new patients

Locations

936 Sharpe Hospital Rd
Weston, WV 26452
Phone (304) 269-1210

Organizations & group practices 3

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": "1487462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489795200000",
    "number": "1922547207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 SHARPE HOSPITAL RD",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528550",
            "telephone_number": "304-269-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 SHARPE HOSPITAL RD",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528550",
            "telephone_number": "304-269-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "TINA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-19",
        "last_updated": "2017-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WV

Sources for this page

Verify at the official NPI Registry.