CATHERINE L SPIKER D.O.
NPI 1760744726
Family Medicine in Newport, TN

Active since June 14, 2012PECOS EnrolledAccepts Medicare Assignment
121 NEWPORT TOWNE CTR, NEWPORT, TN 37821(423) 532-8621(423) 532-8704 Get Directions Write a Review

NPPES record last updated: February 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 8, 2024, Jan 21, 2022, Dec 31, 2020 (3 updates tracked since 2020).

About Catherine L Spiker D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CATHERINE L SPIKER D.O. (NPI 1760744726) is an individual family medicine provider in Newport, Tennessee, licensed in Tennessee (DO2846) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with Morristown Hamblen Hospital Association, and is a graduate of Philadelphia College Of Osteopathic Medicine (2012).

NPPES Registry Identity

NPI1760744726
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCATHERINE L SPIKERCredential: D.O.
Location Address121 NEWPORT TOWNE CTRNewport, TN 37821-7391
Mailing Address121 Newport Towne CtrNewport, TN 37821-7391 · (423) 532-8621 · Fax (423) 532-8704
Fax(423) 532-8704
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2012
Enumeration DateJune 14, 2012
Last NPPES UpdateFebruary 8, 20243 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2024
NPI 1760744726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in TN · DO2846 Licensed in FL · UO 3259
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
121 NEWPORT TOWNE CTR, Newport, TN 37821

Other Identifiers 1

MedicaidQ014182TN

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Catherine L Spiker D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628382249
PECOS Enrollment IDI20150727001923
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 42

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
467 services195 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
233 services156 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
226 services155 patients
Blood test, thyroid stimulating hormone (tsh) 84443
A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
193 services140 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
183 services139 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
164 services31 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Morristown Hamblen Hospital Association

Acute Care Hospitals · Morristown, TN
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number440030
Location908 W 4th North StMorristown, TN 37814 · Hamblen County
Emergency services Birthing friendly

Tennova Healthcare-Jefferson Memorial Hospital

Acute Care Hospitals · Jefferson City, TN
2/5 CMS rating
OwnershipProprietary
CMS Certification Number440056
Location110 Hospital DriveJefferson City, TN 37760 · Jefferson County
Emergency services

Leconte Medical Center

Acute Care Hospitals · Sevierville, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number440081
Location742 Middlecreek RoadSevierville, TN 37862 · Sevier County
Emergency services Birthing friendly

Tennova Healthcare - Newport Medical Center

Acute Care Hospitals · Newport, TN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number440153
Location435 2nd StNewport, TN 37821 · Cocke County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37821 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
1%71 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
63%501 patients3/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
36%504 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
62%764 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
57%228 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%3,543 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%10,933 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
27%527 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%284 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
96%1,516 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
38%908 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,516 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
34%1,516 patients2/55-star benchmark: 89%
Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months
100%21 patients
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
31%1,516 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers17 claims46 services$6.52 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers14 claims14 services$117.53 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers16 claims42 services$44.33 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers12 claims72 services$2.89 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers15 claims15 services$52.56 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers12 claims12 services$12.97 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821
Nurse Practitioner (Family)
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821
Family Medicine
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821
Podiatrist (Foot & Ankle Surgery)
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821
Nurse Practitioner (Family)
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821
Nurse Practitioner (Family)
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821
Family Medicine
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821
Nurse Practitioner
121 NEWPORT TOWNE CTR
NEWPORT, TN 37821

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Catherine Spiker's NPI number?

The NPI number for Catherine Spiker is 1760744726. It was assigned to this individual provider in the NPPES registry on June 14, 2012.

Where is Catherine Spiker located?

Catherine Spiker practices at 121 Newport Towne Ctr, Newport, TN 37821. The listed phone number is (423) 532-8621.

What is Catherine Spiker's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Catherine Spiker enrolled in Medicare?

Yes. Catherine Spiker is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Catherine Spiker accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Catherine Spiker as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Catherine Spiker affiliated with any hospitals?

According to CMS data, Catherine Spiker is affiliated with Morristown Hamblen Hospital Association, Tennova Healthcare-Jefferson Memorial Hospital, Leconte Medical Center and Tennova Healthcare - Newport Medical Center.

When was this NPI record last updated?

The NPPES record for Catherine Spiker was last updated on February 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.