Individual provider Active NPI

Barry A Spoonamore, M.D.

  • Surgery Physician
  • Danville, KY
National Provider Identifier
1952301210
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
24455 Issued in KY
Practice address
210 W Main St
Danville, KY 40422-1812
Phone
(859) 236-0712
Fax
(859) 236-7858
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 24455 KY Primary

Addresses

Primary practice location

210 W Main St
Danville, KY 40422-1812

Mailing address

210 W Main St
Danville, KY 40422-1812
Phone (859) 236-0712

Other identifiers 1

IdentifierTypeStateIssuer
64244551MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4056KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Oral and Facial Surgery PastSince May 18, 2025 Accepting new patients
Anjum Bux, M.D., P.S.C. PastSince Jan 1, 2022 Accepting new patients
Greater Louisville Oral and Maxillofacial Surgery Associates, PSC PastSince Jul 1, 2001 Accepting new patients

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1952301210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W MAIN ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221812",
            "telephone_number": "859-236-0712",
            "fax_number": "859-236-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W MAIN ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221812",
            "telephone_number": "859-236-0712",
            "fax_number": "859-236-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOONAMORE",
        "first_name": "BARRY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "24455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64244551",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.