Individual provider Active NPI

Lisa Spencer

  • General Care Registered Respiratory Therapist
  • Marion, IL
National Provider Identifier
1376893628
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Care Registered Respiratory TherapistTaxonomy code 2279G1100X
License
194006771 Issued in IL
Practice address
2401 W Main St
Marion, IL 62959-1188
Phone
(618) 997-5311
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Care Registered Respiratory Therapist 2279G1100X 194006771 IL Primary

Addresses

Primary practice location

2401 W Main St
Marion, IL 62959-1188

Mailing address

2401 W Main St
Marion, IL 62959-1188
Phone (618) 997-5311

Other identifiers 1

IdentifierTypeStateIssuer
194006771OtherNBRC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
194006771ILMDGeneral Care Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1376893628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279G1100X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, General Care",
            "state": "IL",
            "license": "194006771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBRC",
            "identifier": "194006771",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.