Individual provider Active NPI

Jamie Spencer, NP-C

  • Family Nurse Practitioner
  • South Charleston, WV
National Provider Identifier
1083056345
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN56052 Issued in WV
Practice address
4619 Kanawha Ave SW
South Charleston, WV 25309-1319
Phone
(304) 400-4545
NPI assigned
Jul 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN56052 WV Primary

Addresses

Primary practice location

4619 Kanawha Ave SW
South Charleston, WV 25309-1319

Mailing address

33 Walker Rd
South Charleston, WV 25309-9237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415001817 WV Practitioner - Nurse Practitioner 7810129376 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Hospital & facility affiliations

  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN56052WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jan 1, 2022 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients
THS Physician Partners Inc Family CurrentSince Jun 1, 2023 Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Mar 28, 2022 Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Mar 28, 2022 Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients
Pulmonary Associates of Char LLC CurrentSince Jan 1, 2014 Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

6952 Coal River Rd
#C
Comfort, WV 25049
Phone (304) 307-3116

660 S Main St
#A
Madison, WV 25130
Phone (304) 369-1230

701 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

4619 Kanawha Ave SW
South Charleston, WV 25309
Phone (304) 400-4545

Interoperability endpoints

  • Direct secure messaging: jspencer437212@direct.wvuhsdirect.com

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1083056345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WALKER RD",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253099237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 KANAWHA AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091319",
            "telephone_number": "304-400-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "JAMIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-26",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN56052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.