Colette Mary Spencer, NP

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

451990 Issued in CA

Practice address

8540 S Sepulveda Blvd
Suite 1010
Los Angeles, CA 90045-3807

Phone

(310) 216-1007

NPI assigned

Aug 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment Care Compare group NPD
• Forefront - Murdock Medical Services PC

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1720581473

  CA

  Medicare reassignment
• Prohealth Partners, a Medical Group, Inc.

  • Nephrology Physician
  • Los Alamitos, CA
  • NPI 1154952653
  NPD
• Beach Emergency Medical Associates

  • Emergency Medicine Physician
  • Huntington Beach, CA
  • NPI 1013074996
  NPD (past)
• Rivera Sanatarium Inc

  • Skilled Nursing Facility
  • Pico Rivera, CA
  • NPI 1861580029
  NPD (past)
• Mobile Medical & Nursing, Inc.

  • Nurse Practitioner
  • Palm Beach Gardens, FL
  • NPI 1023123940
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1164613394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "SUITE 1010",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "310-216-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "SUITE 1010",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "310-216-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "COLETTE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "16713",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "CA",
            "license": "451990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saleeta Rena Spencer-Thomas
• Barry Spencer Jr.
• Breauna Marie Spencer, PH.D.
• Brian M Spencer, O.T., CHT
• Brianna Dellinger Spencer, LMFT
• Donielle Spencer
• Ebony Marie Spencer
• Hillard Theophilus Spencer, M.D.
• J.R. Lionel Spencer
• Jody A. Spencer, LICSW

• Critical Care Medicine Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Critical Care Medicine Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.