NPIMap

Individual provider Active NPI

Amy Ruth Spencer, LAC, MACOM

  • Acupuncturist
  • Clackamas, OR
National Provider Identifier
1285962365
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC150496 Issued in OR
Practice address
15240 SE 82ND Dr
Clackamas, OR 97015-9606
Phone
(503) 656-5510
Fax
(503) 656-8080
NPI assigned
Nov 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC150496 OR Primary

Addresses

Primary practice location

15240 SE 82ND Dr
Clackamas, OR 97015-9606

Mailing address

10365 SE Sunnyside Rd.
Suite 210
Clackamas, OR 97015
Phone (503) 887-7725

Other names 1

  • Amy Ruth Stell Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC150496ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
NW Family Wellness Center, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1285962365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD.",
            "address_2": "SUITE 210",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-887-7725",
            "fax_number": "503-855-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15240 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159606",
            "telephone_number": "503-656-5510",
            "fax_number": "503-656-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "AMY",
        "middle_name": "RUTH",
        "credential": "LAC, MACOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-30",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC150496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "STELL",
            "middle_name": "RUTH",
            "credential": "LAC, MACOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.