Active NPI
Spencer M Vila
- Contractor
- Elk Grove, CA
National Provider Identifier
1437560208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 35684
- Practice address
- 9251 Fife Ranch Way
Elk Grove, CA 95624-3575 - Phone
- (815) 514-6686
- NPI assigned
- May 15, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 35684 | CA | Primary |
Addresses
Primary practice location
9251 Fife Ranch Way
Elk Grove, CA 95624-3575
Mailing address
9251 Fife Ranch Way
Elk Grove, CA 95624-3575
Phone (815) 514-6686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12345 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35684 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400112000000",
"number": "1437560208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9251 FIFE RANCH WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956243575",
"telephone_number": "815-514-6686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9251 FIFE RANCH WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956243575",
"telephone_number": "815-514-6686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILA",
"first_name": "SPENCER",
"middle_name": "M",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-15",
"last_updated": "2014-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CA",
"license": "35684",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12345",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.