Melissa J Spencer, ARNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60920612 Issued in WA

Practice address

14410 SE Petrovitsky Rd Ste 209
Renton, WA 98058-8900

Phone

(425) 578-9505

Fax

(425) 578-9505

NPI assigned

Aug 24, 2015

Last updated

May 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Redesign Mental Health, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Renton, WA
  • NPI 1720750706
  NPD

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1164899316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14410 SE PETROVITSKY RD STE 209",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980588900",
            "telephone_number": "425-578-9505",
            "fax_number": "425-207-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14410 SE PETROVITSKY RD STE 209",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980588900",
            "telephone_number": "425-578-9505",
            "fax_number": "425-578-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "MELISSA",
        "middle_name": "J",
        "credential": "ARNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "7421827-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60920612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Junette Sparks-Keeney, OT
• Angela Jeanette Sparks, M.D.
• Sylvia A Spearman, PT
• Leah C Spellen, N.D
• Concetta Spence
• Evelyn Spieker, MN, ARNP
• Russell L Spies, MD
• Harry Samuel Spitzer, MD
• Springbrook Urologic Associates, Inc
• Troy Alan St. Germain, LPN

• Psychiatric/Mental Health Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.