Individual provider Active NPI

Spencer Claussen, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cottonwood, AZ
National Provider Identifier
1255854246
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP10503 Issued in AZ
Practice address
197 S Willard St
Cottonwood, AZ 86326-4123
Phone
(480) 985-1093
Fax
(480) 296-7665
NPI assigned
Jul 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP10503 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP10503 AZ Primary

Addresses

Primary practice location

197 S Willard St
Cottonwood, AZ 86326-4123

Mailing address

PO Box 20610
Mesa, AZ 85277-0610
Phone (480) 985-1093

Other practice location 1

1090 Commerce Dr
Prescott, AZ 86305-3700
Phone (928) 583-1000

Other identifiers 2

IdentifierTypeStateIssuer
316228MedicaidAS
AP10503OtherAZAANP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171026003548 AZ Practitioner - Nurse Practitioner 5092081521 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeline Hospitalist Associates LLCGroup PAC ID 3577961606, 17 clinicians
Arizona Post Acute Care Specialists LLCGroup PAC ID 8527599281, 9 clinicians
Ternion Physician Group, PLLCGroup PAC ID 6709157589, 5 clinicians

Practice addresses (Care Compare)

255 W Brown Rd
Mesa, AZ 85201-3404
Phone (480) 833-3988

4022 E Presidio St
Mesa, AZ 85215-1113
Phone (480) 985-1093

4704 W Diana Ave
Glendale, AZ 85302-5125
Phone (623) 505-9880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Claussen Collaborative Medical Clinic LLC Family CurrentSince Apr 17, 2024 Accepting new patients
County of Yavapai Current Accepting new patients
Lifeline Hospitalist Associates LLC CurrentSince Jan 1, 2024 Accepting new patients
Ternion Physician Group, PLLC Nurse Practitioner CurrentSince Dec 3, 2024 Accepting new patients

Locations

197 S Willard St
Cottonwood, AZ 86326
Phone (801) 296-5111

800 W University Ave
Flagstaff, AZ 86001
Phone (928) 779-6931

4704 W Diana Ave
Glendale, AZ 85302
Phone (623) 247-3949

4022 E Presidio St
Mesa, AZ 85215
Phone (480) 296-7642

255 W Brown Rd
Mesa, AZ 85201
Phone (480) 833-3988

42104 N Venture Dr
Ste D118
Phoenix, AZ 85086
Phone (623) 505-4479

1090 Commerce Dr
Prescott, AZ 86305
Phone (928) 583-1000

Interoperability endpoints

  • Direct secure messaging: spencer.claussen.1@30267.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1255854246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20610",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852770610",
            "telephone_number": "480-985-1093",
            "fax_number": "480-296-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 S WILLARD ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264123",
            "telephone_number": "480-985-1093",
            "fax_number": "480-296-7665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1090 Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863053700",
            "country_code": "US",
            "telephone_number": "928-583-1000",
            "fax_number": "866-323-8458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAUSSEN",
        "first_name": "SPENCER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-21",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10503",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP10503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316228",
            "state": "AS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP",
            "identifier": "AP10503",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.