Individual provider Active NPI

Patricia Lucia Spencer, M.D., M.P.H., M.B.A.

  • Family Medicine Physician
  • Amery, WI
National Provider Identifier
1033347562
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD169044 Issued in OR
Practice address
265 Griffin St E
Amery, WI 54001-1439
Phone
(715) 268-8000
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18705 WI
Family Medicine Physician 207Q00000X MD169044 OR Primary

Addresses

Primary practice location

265 Griffin St E
Amery, WI 54001-1439

Mailing address

PO Box 130
Montezuma Creek, UT 84534-0130
Phone (435) 651-3828

Other practice location 1

Main 130
Montezuma Creek, UT 84534-0130
Phone (435) 651-3828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 18, 2026 through Jun 18, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170309002108 UT Practitioner - Family Practice 4880848894 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Mountain Hospital CurrentSince Mar 1, 2017 Accepting new patients
Utah Navajo Health System, Incorporated Family Medicine CurrentSince Jan 24, 2017 Accepting new patients
Utah Navajo Health System, Incorporated Past Accepting new patients
Utah Navajo Health System, Incorporated Family Medicine Past Accepting new patients

Locations

802 S 200 W
Blanding, UT 84511
Phone (435) 678-3869

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1033347562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "845340130",
            "telephone_number": "435-651-3828",
            "fax_number": "435-651-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 GRIFFIN ST E",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011439",
            "telephone_number": "715-268-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Main 130",
            "address_purpose": "LOCATION",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "845340130",
            "country_code": "US",
            "telephone_number": "435-651-3828",
            "fax_number": "435-651-3786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "PATRICIA",
        "middle_name": "LUCIA",
        "credential": "M.D., M.P.H., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "18705",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD169044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

Verify at the official NPI Registry.