1. Home
  2. Directory
  3. Kentucky
  4. Butler
  5. Nurse Practitioner
  6. NPI Profile

ERIKA SPAULDING APRN
NPI 1770035040
Nurse Practitioner in Butler, KY

Active since November 02, 2016PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
79 COUNTRY CLUB DR, BUTLER, KY 41006(859) 654-2283(859) 654-2284 Get Directions Write a Review

NPPES record last updated: September 11, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2018, Jun 6, 2017, Nov 2, 2016 (3 updates tracked since 2016).

About Erika Spaulding Aprn NPPES

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

ERIKA SPAULDING APRN (NPI 1770035040) is an individual nurse practitioner in Butler, Kentucky, licensed in Kentucky (3010851) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS, is affiliated with St Elizabeth Ft Thomas, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1770035040
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameERIKA SPAULDINGCredential: APRN
Location Address79 COUNTRY CLUB DRButler, KY 41006-8704
Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 654-2283 · Fax (859) 654-2284
Phone(859) 654-2283
Fax(859) 654-2284
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateNovember 2, 2016
Last NPPES UpdateSeptember 11, 20183 updates tracked since enumeration
✔ NPI 1770035040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in KY · 3010851
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 3010851 (KY)
79 COUNTRY CLUB DR, Butler, KY 41006
Open in Google Maps ↗

Other Identifiers 1

Medicaid7100440940KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Erika Spaulding Aprn 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 ID3476832239
PECOS Enrollment IDI20161117002643
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 8

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
138 services95 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
95 services71 patients
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.
75 services54 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
47 services33 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
44 services44 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
44 services20 patients

Hospital Affiliations CMS Care Compare 4

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

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180001
Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County
Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

St Elizabeth Florence

Acute Care Hospitals · Florence, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180045
Location4900 Houston RoadFlorence, KY 41042 · Boone County
Emergency services

St Elizabeth Grant

Critical Access Hospitals · Williamstown, KY
OwnershipVoluntary non-profit - Church
CMS Certification Number181311
Location238 Barnes RoadWilliamstown, KY 41097 · Grant County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41006 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
58%78 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
89%113 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
26%174 patients2/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
26%129 patients2/55-star benchmark: 100%
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 3

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

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier32 claims32 services$4.09 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$63.50 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier13 claims13 services$184.94 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 4

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

CINCINNATI HEALTHCARE GROUP PSC, DBA PATIENT FIRST PHYSICIANS GROUP
Family Medicine
79 COUNTRY CLUB DR
BUTLER, KY 41006
Pendleton County (869) 654-2283
DANIELLE MYERS DO
Family Medicine
79 COUNTRY CLUB DR
BUTLER, KY 41006
Pendleton County (859) 654-2283
JAMES SCHACK M.D.
Family Medicine
79 COUNTRY CLUB DR
BUTLER, KY 41006
Pendleton County (859) 654-2283
MICHAEL G SCHAFER M.D.
Family Medicine
79 COUNTRY CLUB DR
BUTLER, KY 41006
Pendleton County (859) 654-2283

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 Erika Spaulding's NPI number?

The NPI number for Erika Spaulding is 1770035040. It was assigned to this individual provider in the NPPES registry on November 2, 2016.

Where is Erika Spaulding located?

Erika Spaulding practices at 79 Country Club Dr, Butler, KY 41006. The listed phone number is (859) 654-2283.

What is Erika Spaulding's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Erika Spaulding enrolled in Medicare?

Yes. Erika Spaulding 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 Erika Spaulding accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Erika Spaulding 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 Erika Spaulding affiliated with any hospitals?

According to CMS data, Erika Spaulding is affiliated with St Elizabeth Ft Thomas, St Elizabeth Edgewood, St Elizabeth Florence and St Elizabeth Grant.

When was this NPI record last updated?

The NPPES record for Erika Spaulding was last updated on September 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.