Spora Medical, PC.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SPORA MEDICAL, PC.

Practice address

4445 Corporation LN Ste 264
Virginia Beach, VA 23462-3262

Phone

(773) 389-1899

Fax

(773) 466-9777

NPI assigned

Dec 23, 2020

Organization subpart

No

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

Authorized official

Name

Lakisa Davis

Title

Com

Phone

(773) 389-1899

Specialties & licenses 9

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Stephanie Carol Jones Brown, ARNP

  • Family Nurse Practitioner
  • Oakland Park, FL
  • NPI 1639628027
  NPD (past)

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654905600000",
    "number": "1922695949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LN STE 264",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623262",
            "telephone_number": "773-389-1899",
            "fax_number": "773-466-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LN STE 264",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623262",
            "telephone_number": "773-389-1899",
            "fax_number": "773-466-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N Saint Paul St Ste 250",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752013206",
            "country_code": "US",
            "telephone_number": "773-389-8999",
            "fax_number": "773-466-9777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "382 NE 191st St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331793899",
            "country_code": "US",
            "telephone_number": "773-389-1899",
            "fax_number": "773-466-9777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 S 4th St Ste 410",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151419",
            "country_code": "US",
            "telephone_number": "773-389-8999",
            "fax_number": "773-466-9777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9456 State Rd Ste 11-V490",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191143079",
            "country_code": "US",
            "telephone_number": "773-389-8999",
            "fax_number": "773-466-9777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9234 Kingston Pike",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379222380",
            "country_code": "US",
            "telephone_number": "773-389-8999",
            "fax_number": "773-466-9777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPORA MEDICAL, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2022-06-11",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LAKISA",
        "authorized_official_title_or_position": "COM",
        "authorized_official_telephone_number": "773-389-1899"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922695949",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noah William Lee Spencer, RBT
• Rebecca Spencer
• Deja Isabella Spikes, MSW
• Zachary Thomas Splinter, PT, DPT, MS
• Spora Medical, PC.
• Sportsmed, P.C.
• Amber Sprayberry
• Joy J Sprenkle
• Spring Start ABA LLC
• Kimberly Springer, AUD

• Primary Care Clinic/Center in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.