Active NPI
Angela S Spencer, M.D.
- Neurology Physician
- Melbourne, FL
National Provider Identifier
1063476430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- ME0093302
- Practice address
- 2100 N Wickham Rd
Melbourne, FL 32935 - Phone
- (321) 752-7100
- Fax
- (321) 752-7105
- NPI assigned
- Apr 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | ME0093302 | FL | Primary |
Addresses
Primary practice location
2100 N Wickham Rd
Melbourne, FL 32935
Mailing address
2100 N Wickham Rd
Melbourne, FL 32935-8110
Phone (321) 752-7100
Other practice location 1
1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone (321) 434-3533
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00382941 | Other | FL | RR MEDICARE |
| NC002 | Other | FL | FL HF MEDICARE |
| 023440400 | Medicaid | FL | |
| 16273 | Other | FL | BCBS |
| 272830300 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0093302 | FL | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608508800000",
"number": "1063476430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 N WICKHAM RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329358110",
"telephone_number": "321-752-7100",
"fax_number": "321-752-7105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 N WICKHAM RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "32935",
"telephone_number": "321-752-7100",
"fax_number": "321-752-7105"
}
],
"practiceLocations": [
{
"address_1": "1425 Malabar Rd NE",
"address_purpose": "LOCATION",
"city": "Palm Bay",
"state": "FL",
"postal_code": "329072506",
"country_code": "US",
"telephone_number": "321-434-3533",
"fax_number": "321-434-3438",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SPENCER",
"first_name": "ANGELA",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-13",
"last_updated": "2020-12-21",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME0093302",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00382941",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL HF MEDICARE",
"identifier": "NC002",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023440400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "16273",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "272830300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.