Active NPI
Peter G. Spencer, PH.D.
- Clinical Psychologist
- Amherst, MA
National Provider Identifier
1114140985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4972
- Practice address
- 48 N Pleasant St
Suite 202
Amherst, MA 01002-1738 - Phone
- (413) 253-1766
- Fax
- (413) 253-4089
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4972 | MA | Primary |
Addresses
Primary practice location
48 N Pleasant St
Suite 202
Amherst, MA 01002-1738
Mailing address
99 Larkspur Dr
Amherst, MA 01002-3440
Phone (413) 256-6733
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4972 | Other | MA | STATE LICENSE NUMBER |
| 3529-9096 | Other | MD | APA MEMBERSHIP NO. |
| W04700 | Medicaid | MA | |
| 41071 | Other | MA | NAT. REGISTRY NUMBER |
| 0522503 | Other | MD | MASS HEALTH PROVIDER NO. |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4972 | MA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114140985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 LARKSPUR DR",
"city": "AMHERST",
"state": "MA",
"postal_code": "010023440",
"telephone_number": "413-256-6733",
"fax_number": "413-253-4089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 N PLEASANT ST",
"address_2": "SUITE 202",
"city": "AMHERST",
"state": "MA",
"postal_code": "010021738",
"telephone_number": "413-253-1766",
"fax_number": "413-253-4089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "PETER",
"middle_name": "G.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4972",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "4972",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APA MEMBERSHIP NO.",
"identifier": "3529-9096",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "W04700",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NAT. REGISTRY NUMBER",
"identifier": "41071",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS HEALTH PROVIDER NO.",
"identifier": "0522503",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amherst, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.