Spencer Davis

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0579 Issued in NV

Practice address

762 14TH St
Elko, NV 89801-3413

Phone

(775) 738-1553

NPI assigned

Jun 12, 2022

Last updated

Dec 9, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdavis694887@direct.ochin.org
• Direct secure messaging: spencer.davis.p1@direct.nevadahealthcenters.nextgenshare.com

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.

• Nevada Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Carson City, NV
  • NPI 1679649487
  Medicare reassignment
• Nevada Health Centers Inc

  dba Wendover Community Health Center

  • Federally Qualified Health Center (FQHC)
  • West Wendover, NV
  • NPI 1033297304
  NPD
• Nevada Health Centers, Inc

  dba Pahrump Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Pahrump, NV
  • NPI 1326872334
  NPD
• Nevada Health Centers Inc

  dba Elko Family Medical and Dental Center

  • Federally Qualified Health Center (FQHC)
  • Elko, NV
  • NPI 1073690616
  NPD (past)

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1316677578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 14H ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "89801",
            "telephone_number": "775-738-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 14TH ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013413",
            "telephone_number": "775-738-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SPENCER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0579",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dardick - Elko PC (Northeastern Nevada Radiation Oncology)
• David Diehl DMD & Joseph L. Weber DMD PLLC (All Smiles Family Dental Center)
• David M. White DDS & Associates LTD
• Billie Davis
• Brandi L Davis
• Jocelyn B De Guzman, MD
• Vanesa De Jesus
• Debbie Bristol Apn LLC
• Natthanicha Decker
• Felix Quinto Deguzman, MD

• Physician Assistant in Elko, NV
• Providers in Elko, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.