Individual provider Active NPI

Theophilus B Spears

  • Home Modifications Contractor
  • New Orleans, LA
National Provider Identifier
1962055251
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
881200 Issued in LA
Practice address
4121 Saint Claude Ave
New Orleans, LA 70117-5336
Phone
(504) 616-5391
NPI assigned
Jul 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 881200 LA Primary

Addresses

Primary practice location

4121 Saint Claude Ave
New Orleans, LA 70117-5336

Mailing address

4121 Saint Claude Ave
New Orleans, LA 70117-5336
Phone (504) 616-5391

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
881200LAMDHome Modifications Contractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle One LLLC Home Modifications CurrentSince Sep 20, 2022 Accepting new patients

Locations

4121 Saint Claude Ave
New Orleans, LA 70117
Phone (504) 616-5391

Organizations & group practices 1

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1962055251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 SAINT CLAUDE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701175336",
            "telephone_number": "504-616-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 SAINT CLAUDE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701175336",
            "telephone_number": "504-616-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS",
        "first_name": "THEOPHILUS",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "LA",
            "license": "881200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.