Individual provider Active NPI

Dennis Lee Spencer, PA-C, MPAS

  • Medical Physician Assistant
  • Anchorage, AK
National Provider Identifier
1164411989
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAD A 1056 Issued in AK
Practice address
301 Calista CT
Anchorage, AK 99518-3000
Phone
(682) 216-6392
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAD A 1056 AK
Medical Physician Assistant 363AM0700X PAD A 1056 AK Primary

Addresses

Primary practice location

301 Calista CT
Anchorage, AK 99518-3000

Mailing address

301 Calista CT
Anchorage, AK 99518-3000
Phone (682) 216-6392

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAD A 1056AKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1164411989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CALISTA CT",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183000",
            "telephone_number": "682-216-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CALISTA CT",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183000",
            "telephone_number": "682-216-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "DENNIS",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "PAD A 1056",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "PAD A 1056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.