Nathan Spencer, PT

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PT-8584 Issued in ID

Practice address

645 E State St Ste 101
Eagle, ID 83616-5915

Phone

(208) 939-9594

Fax

(208) 939-9828

NPI assigned

Jun 7, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothills Physical Therapy PAGroup PAC ID 9931010014, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Foothills Physical Therapy PA

  • Specialist
  • Meridian, ID
  • NPI 1851457675
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1063106433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E STATE ST STE 101",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165915",
            "telephone_number": "208-939-9594",
            "fax_number": "208-939-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 E STATE ST STE 101",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165915",
            "telephone_number": "208-939-9594",
            "fax_number": "208-939-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "NATHAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PT-8584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Souza, M.S.
• Specialty Labs PLLC
• Speech Tree Inc
• Larisa Speers
• Jaime Beth Spence
• Dorothy Ann Spenner, LCPC, LMFT
• Anna Sprinkel
• Sprouted Therapy
• St Lukes Regional Medical Center
• St. Luke'S Treasure Valley Pediatrics

• Physical Therapy Assistant in Eagle, ID
• Providers in Eagle, ID by specialty
• Physical Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.