Individual provider Active NPI

Spencer Taylor Pickett, DPM

  • Podiatrist
  • Sparks, NV
National Provider Identifier
1104453273
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2093 Issued in NV
Practice address
2321 Pyramid Way
Sparks, NV 89431-8716
Phone
(775) 331-1919
Fax
(775) 331-2008
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2093 NV Primary

Addresses

Primary practice location

2321 Pyramid Way
Sparks, NV 89431-8716

Mailing address

2321 Pyramid Way
Sparks, NV 89431-8716
Phone (763) 311-9197

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012002199 NV Practitioner - Podiatry 5193170082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Institute of Nevada LLCGroup PAC ID 0446536601, 2 clinicians

Practice addresses (Care Compare)

2321 Pyramid Way
Suite B
Sparks, NV 89431-8715
Phone (775) 331-1919

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue37
Removal of skin lesions25
Removal of nail tissue107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2093NVMDPodiatrist

Organizations & group practices 1

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 2

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1104453273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 PYRAMID WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318716",
            "telephone_number": "763-311-9197",
            "fax_number": "775-331-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 PYRAMID WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318716",
            "telephone_number": "775-331-1919",
            "fax_number": "775-331-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "SPENCER",
        "middle_name": "TAYLOR",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "2093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.