Individual provider Active NPI

Caresse Adrienne Spencer, MD

  • Anesthesiology Physician
  • Atlanta, GA
National Provider Identifier
1104112937
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
075155 Issued in GA
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone
(404) 778-7777
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 248672 MA
Internal Medicine Physician 207R00000X 248672 MA
Anesthesiology Physician 207L00000X 075155 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-1059

Mailing address

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 778-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250221001953 MD Practitioner - Anesthesiology 2062644396 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
075155GAMDAnesthesiology Physician
248672MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shock Trauma Associates, P.a. CurrentSince Jan 13, 2025 Accepting new patients
University of Maryland Anesthesiology Associates, P.a. Anesthesiology CurrentSince Jan 13, 2025 Accepting new patients
Georgia Pain and Spine Solutions, PC Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

250 W Pratt St
Ste 900
Baltimore, MD 21201
Phone (410) 328-6267

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18187/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1104112937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-778-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-778-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "CARESSE",
        "middle_name": "ADRIENNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "248672",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "248672",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "075155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.