Stephen E Spencer Sr., MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M3666 Issued in ID

Practice address

6565 W Emerald St
Boise, ID 83704-8737

Phone

(208) 377-5055

Fax

(208) 377-5335

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1376548230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048737",
            "telephone_number": "208-377-5055",
            "fax_number": "208-377-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048737",
            "telephone_number": "208-377-5055",
            "fax_number": "208-377-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M3666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002762400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beatriz C.S. Spencer, PA-C
• Carrie Spencer, RPT
• Jamison Ross Spencer, D.M.D.
• Jane Kelsey Spencer, ACNS
• Jeri K. Spencer, NP
• Susan H Spencer, L.M.T
• Heather Spero, PA
• Melissa Spero, COTA/L
• Michael Spero
• Elena VM Speroff, NP

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.