Individual provider Active NPI

Nathaniel Andrew Spencer, D.O.

  • Student in an Organized Health Care Education/Training Program
  • Charleston, SC
National Provider Identifier
1427582840
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
9228 Medical Plaza Dr
Charleston, SC 29406-9125
Phone
(843) 876-7080
Fax
(843) 876-7111
NPI assigned
Apr 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 97049 GA
Student in an Organized Health Care Education/Training Program 390200000X SC Primary

Addresses

Primary practice location

9228 Medical Plaza Dr
Charleston, SC 29406-9125

Mailing address

126 US Highway 280 W
Americus, GA 31719-8645
Phone (229) 931-1123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20231025000471 GA Practitioner - Diagnostic Radiology 1254682198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

120 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 931-1159

122 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 931-1159

126 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 931-1159

132 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 931-1159

151 Mayo St
Suite B
Americus, GA 31709-4782
Phone (229) 928-2900

151 Mayo St a
Americus, GA 31709-4782
Phone (229) 312-5800

151 Mayo St C
Americus, GA 31709-4782
Phone (229) 928-2882

151 Mayo St D
Americus, GA 31709-4782
Phone (229) 928-1100

151 Mayo St E
Americus, GA 31709-4782
Phone (229) 931-1159

2336 Dawson Rd
Suite 1600
Albany, GA 31707-2801
Phone (229) 312-8750

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-5222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Oct 1, 2023 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1427582840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 US HIGHWAY 280 W",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317198645",
            "telephone_number": "229-931-1123",
            "fax_number": "229-931-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 MEDICAL PLAZA DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069125",
            "telephone_number": "843-876-7080",
            "fax_number": "843-876-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "NATHANIEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "97049",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.