Individual provider Active NPI

Phillip Mansfield Spaur, DC

  • Chiropractor
  • Weston, WV
National Provider Identifier
1972605608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
538 Issued in WV
Practice address
346 East 3Rd Street
Weston, WV 26452
Phone
(304) 269-5253
Fax
(304) 269-5253
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 538 WV Primary

Addresses

Primary practice location

346 East 3Rd Street
Weston, WV 26452

Mailing address

PO Box 30
346 East 3Rd Street
Weston, WV 26452
Phone (304) 269-5253

Other identifiers 1

IdentifierTypeStateIssuer
7600046MedicaidWV

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

State licenses

LicenseStateTypeSpecialty
538WVMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972605608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30",
            "address_2": "346 EAST 3RD STREET",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "26452",
            "telephone_number": "304-269-5253",
            "fax_number": "304-269-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 EAST 3RD STREET",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "26452",
            "telephone_number": "304-269-5253",
            "fax_number": "304-269-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAUR",
        "first_name": "PHILLIP",
        "middle_name": "MANSFIELD",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600046",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.