Individual provider Active NPI

Sarah C Spencer, ARNP

  • Pediatric Nurse Practitioner
  • Centralia, WA
National Provider Identifier
1336127299
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP30004257 Issued in WA
Practice address
1911 Cooks Hill Rd
Centralia, WA 98531-9073
Phone
(360) 736-6778
Fax
(360) 736-6552
NPI assigned
Jan 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP30004257 WA Primary

Addresses

Primary practice location

1911 Cooks Hill Rd
Centralia, WA 98531-9073

Mailing address

1911 Cooks Hill Rd
Centralia, WA 98531-9073
Phone (360) 736-6778

Other identifiers 1

IdentifierTypeStateIssuer
9643156OtherWADSHS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2016 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30004257WAMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: sspencer@nwpc.opdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1336127299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319073",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319073",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "SARAH",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-02",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30004257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS NUMBER",
            "identifier": "9643156",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

Verify at the official NPI Registry.