MR. FREDERICK THOMAS SPORCK (NPI# 1417956780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417956780 |
| Entity Type | Individual |
| Full Name | MR. FREDERICK THOMAS SPORCK |
| Credential | MD |
| Practice Address |
500 Donnally St Suite 200 Charleston WV 25301-1648 |
| Mailing Address |
Po Box 1628 Charleston WV 25326-1628 |
| Practice Telephone | 3043420124 |
| Practice Fax Number | 3043402204 |
| Mailing Telephone | 3043420124 |
| Mailing Fax Number | 3043402204 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 09647 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BC/BS | 550595497010 | 01 |
| WV | CIGNA | 58009 | 01 |
| WV | 0101387000 | 05 | |
| AETNA | 4242674 | 01 |
| Street Address |
500 DONNALLY ST SUITE 200 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25301-1648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578990917 | Laura Michelle Cunningham | Nurse Practitioner | 500 Donnally St, Suite 200, Charleston, WV 25301-1648 | 2013-09-30 |
| 1457632770 | D Rachelle Miano | Audiologist | 500 Donnally St, Charleston, WV 25301-1648 | 2011-08-31 |
| 1285895938 | Mark Allen Richards | Family Medicine | 500 Donnally St, Suite 203, Charleston, WV 25301-1648 | 2008-06-24 |
| 1285892828 | Brenda Diane George | Audiologist | 500 Donnally St, Charleston, WV 25301-1648 | 2008-05-30 |
| 1144488214 | Susan Diane Maynard | Audiologist | 500 Donnally St, Suite 200, Charleston, WV 25301-1648 | 2008-05-27 |
| 1629236724 | Melissa Ann White | Audiologist | 500 Donnally St, Charleston, WV 25301-1648 | 2008-05-27 |
| 1134305089 | Integrated Health Care Providers, Inc. | Durable Medical Equipment & Medical Supplies | 500 Donnally St, Ste 100, Charleston, WV 25301-1648 | 2008-01-10 |
| 1275732216 | Jennifer Jeanette Ladd | Family Medicine | 500 Donnally St, Suite 203, Charleston, WV 25301-1648 | 2007-07-11 |
| 1265565386 | Katheryn Seymour Monk | Audiologist | 500 Donnally St, Suite 200, Charleston, WV 25301-1648 | 2007-03-14 |
| 1760515100 | Jaime G. Gorby | Audiologist | 500 Donnally St, Suite 102, Charleston, WV 25301-1648 | 2007-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087680 | Kerrie Rena Harris | Counselor | 16 Leon Sullivan Way Suite 300, Charleston, WV 25301 | 2020-09-15 |
| 1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1740638022 | Christina Phalen | Pharmacy Technician | 701 Lee Street East, Charleston, WV 25301 | 2016-05-27 |
| 1366867079 | Brooke Powell Garnes | Speech-Language Pathologist | 1313 Quarrier Street, Suite A, Charleston, WV 25301 | 2014-03-04 |
| 1952648404 | Implanted Pump Management, LLC | Home Infusion | 311 Laidley St., Suite 202, Charleston, WV 25301 | 2013-01-03 |
| 1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
| 1033477278 | James Stephen Harman | Neurological Surgery | 415 Morris St Ste 400, Charleston, WV 25301 | 2012-04-25 |
| 1265674329 | Howard and Howard Dental LLC | Dentist | 1321 Virginia St., Charleston, WV 25301 | 2009-04-03 |
| 1881856144 | Steven David Hollosi | Emergency Medicine | 501 Morris St., Charleston, WV 25301 | 2008-06-27 |
| Find all providers in zip 25301 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932667276 | Brendan Hardy | Otolaryngology | 135 Rutledge Ave Ste 1130, Charleston, SC 29425 | 2019-03-06 |
| 1538696091 | Michael Richard Bobian | Otolaryngology | 135 Rutledge Ave # Msc550, Charleston, SC 29425-8903 | 2017-05-16 |
| 1194150573 | Sarfaraz Mubarak Banglawala | Otolaryngology | Musc Dept of Otolaryngology Head and Neck, 135 Rutledge Avenue, Charleston, SC 29425-0001 | 2013-09-04 |
| 1457614703 | Travis Parke Schrank | Otolaryngology | Otolaryngology Head and Neck Surgery, 135 Rutledge Ave Msc 550, Charleston, SC 29425-0001 | 2012-06-21 |
| 1215268578 | Newton Gaston Quantz Jr. | Otolaryngology | 401 Ralston Creek Street, Charleston, SC 29492 | 2010-01-26 |
| 1386871499 | Shaun A Nguyen | Otolaryngology | 135 Rutledge St # Msc550, Charleston, SC 29425-8903 | 2009-06-16 |
| 1568469435 | Carl Willy Schwenzfeier | Otolaryngology | 497 Saint Andrews Blvd, Charleston, SC 29407-7184 | 2005-07-06 |
| 1669479986 | Edward G Behrens | Otolaryngology | 1849 Savage Rd, Charleston, SC 29407-4726 | 2005-07-01 |
| 1558367433 | Robert Charles Jordan | Otolaryngology | 2295 Henry Tecklenburg Dr, Charleston, SC 29414-7801 | 2005-06-24 |
| 1235756578 | Joel Christopher Davies | Otolaryngology | 135 Rutledge Ave, Charleston, SC 29425-8903 | 2020-07-02 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25301 |
Please comment or provide details below to improve the information on MR. FREDERICK THOMAS SPORCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.