Individual provider Active NPI

Andrea B Spencer, OTR/L

  • Occupational Therapist
  • Tupelo, MS
National Provider Identifier
1093066078
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT1017 Issued in MS
Practice address
1211 S Gloster St Ste C
Tupelo, MS 38801-6548
Phone
(662) 432-1523
NPI assigned
Oct 1, 2012
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT1017 MS Primary

Addresses

Primary practice location

1211 S Gloster St Ste C
Tupelo, MS 38801-6548

Mailing address

1211 S Gloster St
Tupelo, MS 38801-6546
Phone (662) 432-1523

Other practice location 1

2714 W Oxford Loop
Ste 164
Oxford, MS 38655-5717
Phone (662) 232-8949

Other names 1

  • Ms. Andrea B Crane Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121113000173 MS Practitioner - Occupational Therapist in Private Practice 0345491759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sog Physical TherapyGroup PAC ID 1850627209, 20 clinicians
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1211 S Gloster St
Suite C
Tupelo, MS 38801-6548
Phone (662) 432-1523

2205 Jefferson Davis Dr
Oxford, MS 38655-5221
Phone (662) 238-2800

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT1017MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Occupational Therapist CurrentSince Nov 15, 2021 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Nov 15, 2021 Accepting new patients
Sog Physical Therapy Occupational Therapist CurrentSince Aug 18, 2025 Accepting new patients
Specialty Orthopedic Group of Ms, PLLC PastSince Aug 18, 2025 Accepting new patients

Locations

1945 Scottsville Rd
Ste B2
Bowling Green, KY 42104
Phone (270) 781-4828

171 Lakewood Dr
Ste 2
Batesville, MS 38606
Phone (662) 563-2579

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

2205 Jefferson Davis Dr
Oxford, MS 38655
Phone (662) 238-2800

2714 West Oxford Loop
Ste 164
Oxford, MS 38655
Phone (662) 232-8949

105B Quality Ln
Senatobia, MS 38668
Phone (662) 562-9977

118 Highway 12 W
Ste 1
Starkville, MS 39759
Phone (662) 432-1523

1211 S Gloster St
Ste C
Tupelo, MS 38801
Phone (662) 432-1523

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1093066078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016546",
            "telephone_number": "662-432-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST STE C",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016548",
            "telephone_number": "662-432-1523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2714 W OXFORD LOOP",
            "address_2": "STE 164",
            "address_purpose": "LOCATION",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555717",
            "country_code": "US",
            "telephone_number": "662-232-8949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "ANDREA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT1017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "CRANE",
            "middle_name": "B",
            "prefix": "MS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.