Individual provider Active NPI

Thomas Richmond Spencer, PHD PSYD

  • Psychologist
  • Pensacola, FL
National Provider Identifier
1063440824
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY4097 Issued in FL
Practice address
600 East Government Street
Pensacola, FL 32502
Phone
(850) 434-5033
Fax
(850) 433-0268
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY4097 FL Primary

Addresses

Primary practice location

600 East Government Street
Pensacola, FL 32502

Mailing address

600 East Government Street
Pensacola, FL 32502
Phone (850) 434-5033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120322000548 FL Practitioner - Clinical Psychologist 3678537438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Associates, P.aGroup PAC ID 1052388014, 10 clinicians

Practice addresses (Care Compare)

1120 N Palafox St
Pensacola, FL 32501-2608
Phone (850) 434-5033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4097FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Associates, P.a. CurrentSince Sep 26, 2002 Accepting new patients

Locations

600 E Government St
Pensacola, FL 32502
Phone (850) 434-5033

1120 N Palafox St
Pensacola, FL 32501
Phone (850) 434-5033

Organizations & group practices 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1063440824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 EAST GOVERNMENT STREET",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32502",
            "telephone_number": "850-434-5033",
            "fax_number": "850-433-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST GOVERNMENT STREET",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32502",
            "telephone_number": "850-434-5033",
            "fax_number": "850-433-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "THOMAS",
        "middle_name": "RICHMOND",
        "credential": "PHD PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY4097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.