Active NPI
Susan J Spencer, PAC
- Surgical Physician Assistant
- Lincoln, NE
National Provider Identifier
1235224510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 941
- Practice address
- 7440 S 91St St
Lincoln, NE 68526-9797 - Phone
- (402) 489-6555
- Fax
- (402) 328-3770
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 941 | NE | |
| Medical Physician Assistant | 363AM0700X | 941 | NE | |
| Surgical Physician Assistant | 363AS0400X | 941 | NE | Primary |
Addresses
Primary practice location
7440 S 91St St
Lincoln, NE 68526-9797
Mailing address
2000 Q St
Suite 500
Lincoln, NE 68503-3609
Phone (402) 328-4922
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10026072600 | Medicaid | NE | |
| 10026072500 | Medicaid | NE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nebraska Heart Institute PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Lincoln, NE
- NPI 1336125202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370304000000",
"number": "1235224510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 Q ST",
"address_2": "SUITE 500",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685033609",
"telephone_number": "402-328-4922",
"fax_number": "402-421-0946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7440 S 91ST ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685269797",
"telephone_number": "402-489-6555",
"fax_number": "402-328-3770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2013-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "941",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NE",
"license": "941",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NE",
"license": "941",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026072600",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026072500",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.