Individual provider Active NPI

Kathryn Neupert Spencer, M.D.

  • Pediatric Allergy/Immunology Physician
  • Baton Rouge, LA
National Provider Identifier
1336535525
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
308717 Issued in LA
Practice address
8200 Constantin Blvd FL 3
Baton Rouge, LA 70809-3481
Phone
(225) 765-5500
Fax
(225) 765-4378
NPI assigned
Apr 14, 2015
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 308717 LA
Pediatrics Physician 208000000X BP10053060 TX
Pediatric Allergy/Immunology Physician 2080P0201X 308717 LA Primary

Addresses

Primary practice location

8200 Constantin Blvd FL 3
Baton Rouge, LA 70809-3481

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5500

Other practice location 1

4900 Mueller Blvd
Ste 3S.066C
Austin, TX 78723-3079
Phone (512) 324-0165

Other practice location 2

5000 Odonavan Blvd Ste 507
Walker, LA 70785-6352
Phone (225) 765-5500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kneupert1319408@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200729001164 LA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 1850643313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8200 Constantin Blvd
Baton Rouge, LA 70809-3481
Phone (225) 765-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
308717LAMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Pediatrics Current Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Aug 31, 2020 Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Aug 31, 2020 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Total Care Medical Center of Southeast Louisiana, Inc. Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8200 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 765-5000

8200 Constantin Blvd
Fl 3
Baton Rouge, LA 70809
Phone (225) 765-1982

1931 S Burnside Ave
Gonzales, LA 70737
Phone (225) 647-7246

1937 S Burnside Ave
Gonzales, LA 70737
Phone (225) 647-1947

5000 Odonavan Blvd
Ste 404
Walker, LA 70785
Phone (225) 369-8100

5000 Odonavan Blvd
Ste 507
Walker, LA 70785
Phone (225) 214-3199

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1336535525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 CONSTANTIN BLVD FL 3",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093481",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-4378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Mueller Blvd",
            "address_2": "Ste 3S.066C",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787233079",
            "country_code": "US",
            "telephone_number": "512-324-0165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 Odonavan Blvd Ste 507",
            "address_purpose": "LOCATION",
            "city": "Walker",
            "state": "LA",
            "postal_code": "707856352",
            "country_code": "US",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-4378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "KATHRYN",
        "middle_name": "NEUPERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "308717",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10053060",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "LA",
            "license": "308717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kneupert1319408@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kneupert1319408@direct.casso.us.com",
            "address_1": "8200 Constantin Blvd Fl 3",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093481",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8200 Constantin Blvd Fl 3",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.