Lori J Spencer, APNP
Individual provider Active NPI Nurse Practitioner · Wisconsin Dells, WI
NPI 1235588773 · NPPES record last updated Dec 12, 2020
Key facts
- NPI
- 1235588773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 6930-033 (WI)
- Practice address
- 1310 Broadway
Wisconsin Dells, WI 53965-1358 - Phone
- (608) 253-1171
- Fax
- (608) 253-8012
- NPI assigned
- Jun 6, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Dean Health Systems Inc
The Psychology Center S C
Practice addresses (Care Compare)
1310 Broadway
Wisconsin Dells, WI 53965-1358
Phone (608) 253-1171
7617 Mineral Point Rd
Suite 300
Madison, WI 53717-1623
Phone (608) 833-9290
Hospital & facility affiliations
- Agrace Hospicecare
- SSM Health at Home Hospice
- SSM Health St Clare Hospital - Baraboo
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160624001380 | WI | Practitioner - Nurse Practitioner | 6204979040 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6930-033 | WI | MD | Nurse Practitioner |
| 6930-33 | WI | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc. | Current |
Accepting new patients | |
| The Psychology Center S C | Current |
Accepting new patients | |
| Dean Health Systems, Inc | Current |
Accepting new patients |
Locations
7617 Mineral Point Rd
Madison, WI 53717
Phone (608) 833-9290
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
7617 Mineral Point Rd
Ste 300
Madison, WI 53717
Phone (608) 833-9290
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
1310 Broadway
Wisconsin Dells, WI 53965
Phone (608) 253-1171
Interoperability endpoints
- lspencer263393@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 6930-33 | WI | |
| Nurse Practitioner | 363L00000X | 6930-033 | WI | Yes |
Addresses
Primary practice location
1310 Broadway
Wisconsin Dells, WI 53965-1358
Mailing address
1310 Broadway
Wisconsin Dells, WI 53965-1358
Phone (608) 253-1171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235588773 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lspencer263393@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Other providers in Wisconsin Dells, WI
- Gregory Richard Rowe
- Mary Ellen Sabourin
- School District of Wisconsin Dells
- Erik R Snortum
- Jennifer L. Spady
- SSM Health Care of Wisconsin Inc
- Jennifer L Stremcha
- Jeffrey Sveum
- Patrick F Sweeney
- Asfiya Batool Syeda
All providers in Wisconsin Dells, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.