Spencer John Mares, FNP-C, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

2023006109 Issued in MO

Practice address

100 Medical PLZ
Lake Saint Louis, MO 63367-1366

Phone

(636) 625-5200

NPI assigned

Jan 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of Illinois LLC 193 clinicians

SSM Medical Group Inc 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smares30086@direct-ehr-ssmhc.com

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.

• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  MO

  Medicare reassignment Care Compare group NPD
• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207

  MO

  Medicare reassignment Care Compare group NPD
• The Health & Wellness Centerr LLC

  • Primary Care Nurse Practitioner
  • Saint Louis, MO
  • NPI 1932627486

  MO

  Medicare reassignment NPD
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wentzville, MO
  • NPI 1043518350
  Care Compare group
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Bridgeton, MO
  • NPI 1053616110
  Care Compare group
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Saint Charles, MO
  • NPI 1437573920
  Care Compare group
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Saint Charles, MO
  • NPI 1447633557
  Care Compare group
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Bridgeton, MO
  • NPI 1477564581
  Care Compare group
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Troy, MO
  • NPI 1528503133
  Care Compare group
• SSM Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Florissant, MO
  • NPI 1194736116
  Care Compare group
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Warrenton, MO
  • NPI 1467997155
  NPD
• Doctors on the Go LLC

  • Internal Medicine Physician
  • Olivette, MO
  • NPI 1134532419
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1437667490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEADOW RUN CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633035805",
            "telephone_number": "636-485-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PLZ",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671366",
            "telephone_number": "636-625-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARES",
        "first_name": "SPENCER",
        "middle_name": "JOHN",
        "credential": "FNP-C, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-11",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018001739",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.000663",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2023006109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maggie Lovette
• Loving Grace Health Care LLC
• Gregory A. Luerding, DDS
• Bonnie Luna, M.ED. LPC, CCTP
• Erin Lynch, MSW
• Elise Maria Marker, MD
• Elle Marie Martirez
• Jessica Lee Masulla, PHARMD
• Karalynn Matthews, RN
• Melanie V Maze, ANP, BC

• All providers in Lake Saint Louis, MO
• Acute Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.