Richard L Spencer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9475 Issued in GA

Practice address

2101 Osborne Rd
Saint Marys, GA 31558-9137

Phone

(912) 882-6072

Fax

(912) 882-6610

NPI assigned

Nov 8, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255401204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 OSBORNE RD",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315589137",
            "telephone_number": "912-882-6072",
            "fax_number": "912-882-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 OSBORNE RD",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315589137",
            "telephone_number": "912-882-6072",
            "fax_number": "912-882-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "581455186",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Chiropractic LLC
• Southeast Georgia Health System, Inc. (Southeast Georgia Health System - Camden Campus)
• Southeast Georgia Health System, Inc. (Senior Care Center - St. Marys)
• Southeast Georgia Radiology
• Bonnie Renee Spencer, LAPC
• St. Marys Obstetrics & Gynecology, P. C. (St. Marys OB/GYN, P. C.)
• St. Marys Psychiatry, Inc.
• Cassey St.Rose, LPC
• Stanley M. Prince, DMD,PC
• Hailey Ann Staszewski, DPT

• General Practice Dentistry in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.