Individual provider Active NPI

John Rexford Spence, D.C.

  • Chiropractor
  • Clifton Park, NY
National Provider Identifier
1407052152
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0058821 Issued in NY
Practice address
1 Barney Rd
Ste. 108
Clifton Park, NY 12065-5843
Phone
(518) 348-1935
Fax
(518) 348-1936
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0058821 NY Primary

Addresses

Primary practice location

1 Barney Rd
Ste. 108
Clifton Park, NY 12065-5843

Mailing address

1 Barney Rd
Ste. 108
Clifton Park, NY 12065-5843
Phone (518) 348-1935

Other identifiers 2

IdentifierTypeStateIssuer
C058828-8OtherNYNYS WORKERS' COMPENSATION
10018818OtherNYCDPHP

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0058821NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1407052152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARNEY RD",
            "address_2": "STE. 108",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120655843",
            "telephone_number": "518-348-1935",
            "fax_number": "518-348-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNEY RD",
            "address_2": "STE. 108",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120655843",
            "telephone_number": "518-348-1935",
            "fax_number": "518-348-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "JOHN",
        "middle_name": "REXFORD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0058821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS WORKERS' COMPENSATION",
            "identifier": "C058828-8",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10018818",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; 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.