Edward C Spoon Jr MD LTD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

6595 Issued in NV

Legal business name

EDWARD C SPOON JR MD LTD

Practice address

2010 Goldring Ave
200
Las Vegas, NV 89106-4002

Phone

(702) 382-2900

Fax

(702) 382-1980

NPI assigned

Oct 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Edward Carey Spoon Jr., MDNPI 1528060183

Title

President

Phone

(702) 382-2900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• LAS VEGAS OB/GYN ASSOCIATES Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

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

• Edward Carey Spoon Jr., MD

  • Obstetrics & Gynecology Physician
  • Las Vegas, NV
  • NPI 1528060183
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1992058192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 GOLDRING AVE",
            "address_2": "200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064002",
            "telephone_number": "702-382-2900",
            "fax_number": "702-382-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 GOLDRING AVE",
            "address_2": "200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064002",
            "telephone_number": "702-382-2900",
            "fax_number": "702-382-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD C SPOON JR MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "SPOON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "CAREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-382-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "6595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN TYPE 1",
            "identifier": "V30374",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019518",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAS VEGAS OB/GYN ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Educare Community Living Corporation - Nevada
• Educare Community Living Corporation - Nevada
• Educare Community Living Corporation - Nevada
• Educare Community Living Corporation - Nevada
• Educated Athletics LTD.
• Edward J Malik OD Chartered and Associates
• Edward K Tsai
• Edward Outlaw, MD, PC
• Edward S. Victoria, PLLC
• Corrine Gillen Edward, LPN

• Obstetrics & Gynecology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Obstetrics & Gynecology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.