Spek Diagnostics, Inc

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

Legal business name

SPEK DIAGNOSTICS, INC

Practice address

155 E 50TH St
Garden City, ID 83714-1413

Phone

(208) 854-9323

NPI assigned

Aug 18, 2022

Last updated

Oct 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Nathan Lennberg, CPA

Title

Cfo

Phone

(208) 854-9323

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gabriel Eli Morey, MD MPH

  • Anatomic Pathology & Clinical Pathology Physician
  • Garden City, ID
  • NPI 1639563547

  Dermatopathology

  Medicare reassignment NPD
• Samantha Wynn Johnson, NP

  • Family Nurse Practitioner
  • Twin Falls, ID
  • NPI 1164141107
  NPD
• Bradley Martin, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Twin Falls, ID
  • NPI 1114536737
  NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1376261040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E 50TH ST",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141413",
            "telephone_number": "208-609-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E 50TH ST",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141413",
            "telephone_number": "208-854-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEK DIAGNOSTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-10-19",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "LENNBERG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-854-9323",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "TBD",
            "affiliation": "N",
            "endpointDescription": "Interface for Pathology lab orders and result",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HL7",
            "address_1": "155 E 50th St",
            "city": "Garden City",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837141413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Roybal
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• Romina Marie Schnelle
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• Terrence A Stoll, M.D.
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• Dermatopathology (Pathology) Physician in Garden City, ID
• Providers in Garden City, ID by specialty
• Dermatopathology (Pathology) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.