Individual provider Active NPI

Danielle Destiny Spencer

  • Community Health Registered Nurse
  • Syracuse, NY
National Provider Identifier
1033072830
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
N05725-01 Issued in NY
Practice address
620 Erie Blvd W
Syracuse, NY 13204-2445
Phone
(315) 551-2985
NPI assigned
Dec 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC1500X N05725-01 NY Primary

Addresses

Primary practice location

620 Erie Blvd W
Syracuse, NY 13204-2445

Mailing address

620 Erie Blvd W
Syracuse, NY 13204-2445
Phone (315) 551-2985

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
N05725-01NYMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1033072830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042445",
            "telephone_number": "315-551-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042445",
            "telephone_number": "315-551-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "DANIELLE",
        "middle_name": "DESTINY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "NY",
            "license": "N05725-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.