Kevin Taylor Spence

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

E-17872 Issued in AR

Practice address

12600 Cantrell Rd
Little Rock, AR 72223-1604

Phone

(501) 605-7676

NPI assigned

Jun 25, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1073174678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UPMC PINNACLE 205 S FRONT ST",
            "address_2": "GENERAL SURGERY RESIDENCY BRADY 916",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17104",
            "telephone_number": "717-231-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 CANTRELL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231604",
            "telephone_number": "501-605-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "KEVIN",
        "middle_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT219075",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-17872",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT219075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia E Speed, MD
• Ramie C Speed
• Amber Leigh Speer, RN
• Samantha Speer, MHPP
• Kathryn Speights, PA-C
• Judith Chinwe Spencer-Cole, FNP
• Kyle R Spencer
• Lauren Ashley Spencer, OTR/L
• Michael Spencer
• Monica Alicia Spencer

• Surgery Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.