NPIMap

Organization Active NPI

Tresa Roebuck Spencer, PHD, PLLC

  • Clinical Neuropsychologist
  • Edmond, OK
National Provider Identifier
1265674824
Registry record updated Mar 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1078 Issued in OK
Legal business name
TRESA ROEBUCK SPENCER, PHD, PLLC
Practice address
1317 Bay Bridge CT
Edmond, OK 73034-7076
Phone
(405) 513-5741
NPI assigned
Mar 28, 2009
Last updated
Mar 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2009

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

Authorized official

Name
Tresa Michelle Roebuck Spencer, PH.D.
Title
Manager
Phone
(703) 863-1840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 1078 OK Primary

Addresses

Primary practice location

1317 Bay Bridge CT
Edmond, OK 73034-7076

Mailing address

1317 Bay Bridge CT
Edmond, OK 73034-7076
Phone (405) 513-5741

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1238198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238198400000",
    "number": "1265674824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 BAY BRIDGE CT",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347076",
            "telephone_number": "405-513-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 BAY BRIDGE CT",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347076",
            "telephone_number": "405-513-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRESA ROEBUCK SPENCER, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-28",
        "last_updated": "2009-03-28",
        "status": "A",
        "authorized_official_last_name": "ROEBUCK SPENCER",
        "authorized_official_first_name": "TRESA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "703-863-1840",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "OK",
            "license": "1078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.