Individual provider Active NPI

Spencer Craig Checketts, MD, MPH

  • Occupational Medicine Physician
  • Brigham City, UT
National Provider Identifier
1073507893
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
359818-1205 Issued in UT
Practice address
111 E Forest St # 1
Brigham City, UT 84302-3603
Phone
(435) 553-4787
Fax
(435) 239-7089
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 359818-1205 UT Primary

Addresses

Primary practice location

111 E Forest St # 1
Brigham City, UT 84302-3603

Mailing address

111 E Forest St # 1
Brigham City, UT 84302-3603
Phone (435) 553-4787

Other practice location 1

Unit 5210 Box 230
Apo, AE 09461
GB
Phone 441638528040

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

Interoperability endpoints

  • Direct secure messaging: spencer.checketts@3104.securemail.prognocis.com

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073507893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E FOREST ST # 1",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023603",
            "telephone_number": "435-553-4787",
            "fax_number": "435-239-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E FOREST ST # 1",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023603",
            "telephone_number": "435-553-4787",
            "fax_number": "435-239-7089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Unit 5210 Box 230",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "09461",
            "country_code": "GB",
            "telephone_number": "441638528040",
            "country_name": "Great Britain",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "CHECKETTS",
        "first_name": "SPENCER",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "UT",
            "license": "359818-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.