Active NPI
Dan R Spearman, MD
- Pediatrics Physician
- Orange Park, FL
National Provider Identifier
1962475905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME20998
- Practice address
- 2140 Smith St
Orange Park, FL 32073-5554 - Phone
- (904) 269-2145
- Fax
- (904) 278-5038
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME20998 | FL | Primary |
Addresses
Primary practice location
2140 Smith St
Orange Park, FL 32073-5554
Mailing address
PO Box 45443
Salt Lake City, UT 84145-0443
Phone (904) 202-1032
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0351113-00 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME20998 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545350400000",
"number": "1962475905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 45443",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841450443",
"telephone_number": "904-202-1032",
"fax_number": "904-376-4107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 SMITH ST",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735554",
"telephone_number": "904-269-2145",
"fax_number": "904-278-5038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEARMAN",
"first_name": "DAN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2018-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME20998",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0351113-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.