NPIMap

Individual provider Active NPI

Thomas S Spencer, MD

  • Obstetrics & Gynecology Physician
  • Knox, IN
National Provider Identifier
1295796985
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01053871A Issued in IN
Practice address
104 E Culver Rd
Suite 103
Knox, IN 46534-2216
Phone
(574) 772-2114
Fax
(574) 772-2802
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 22329 OK
Obstetrics & Gynecology Physician 207V00000X 01053871A IN Primary

Addresses

Primary practice location

104 E Culver Rd
Suite 103
Knox, IN 46534-2216

Mailing address

2335 W Brooks Bluff
North Judson, IN 46366
Phone (574) 933-1420

Other identifiers 2

IdentifierTypeStateIssuer
000000518052OtherINANTHEM BLUE CROSS
200860120MedicaidIN

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01053871AINMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Past Accepting new patients
Okmulgee Emergency PLLC Emergency Medical Services Past Accepting new patients
Honeywell Emergency Physicians Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 3

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1295796985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 W BROOKS BLUFF",
            "city": "NORTH JUDSON",
            "state": "IN",
            "postal_code": "46366",
            "telephone_number": "574-933-1420",
            "fax_number": "574-772-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E CULVER RD",
            "address_2": "SUITE 103",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "465342216",
            "telephone_number": "574-772-2114",
            "fax_number": "574-772-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "THOMAS",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "22329",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01053871A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000518052",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200860120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knox, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.