Individual provider Active NPI

Spencer O'Brien Carden, PA-C

  • Physician Assistant
  • Ringgold, GA
National Provider Identifier
1144072836
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
45 College Park Dr
Ringgold, GA 30736-0600
Phone
(706) 965-4060
NPI assigned
Apr 4, 2024
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

45 College Park Dr
Ringgold, GA 30736-0600

Mailing address

102 McFarland Rd Apt 3
Lookout Mountain, GA 30750-3127
Phone (812) 208-5462

Other names 1

  • Spencer O'Brien Grim Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240802000395 GA Practitioner - Physician Assistant 6305383753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Physician Group, IncGroup PAC ID 4789708553, 120 clinicians

Practice addresses (Care Compare)

1432 Broadrick Dr
Dalton, GA 30720-3009
Phone (706) 226-8990

1436 Broadrick Dr
Suite B
Dalton, GA 30720-3009
Phone (706) 226-3434

45 College Park Dr
Ringgold, GA 30736-0600
Phone (706) 529-7440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Medical Center, Inc. Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1144072836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MCFARLAND RD APT 3",
            "city": "LOOKOUT MOUNTAIN",
            "state": "GA",
            "postal_code": "307503127",
            "telephone_number": "812-208-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 COLLEGE PARK DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307360600",
            "telephone_number": "706-965-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDEN",
        "first_name": "SPENCER",
        "middle_name": "O'BRIEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SPENCER",
            "last_name": "GRIM",
            "middle_name": "O'BRIEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ringgold, GA

Sources for this page

Verify at the official NPI Registry.