Active NPI
Andrew Spencer
- Athletic Trainer
- Grand Island, NE
National Provider Identifier
1174178388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 783
- Practice address
- 3535 W 13TH St Ste 121
Grand Island, NE 68803-3302 - Phone
- (308) 675-1853
- NPI assigned
- Aug 5, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 783 | NE | Primary |
Addresses
Primary practice location
3535 W 13TH St Ste 121
Grand Island, NE 68803-3302
Mailing address
1904 Meadow Rd
Grand Island, NE 68803-1583
Phone (308) 850-7766
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 783 | NE | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1174178388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1904 MEADOW RD",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688031583",
"telephone_number": "308-850-7766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 W 13TH ST STE 121",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688033302",
"telephone_number": "308-675-1853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.