Barry Dwayne Spencer, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA3784 Issued in MS

Practice address

8 Cambridge Dr
Tupelo, MS 38801-6126

Phone

(662) 231-0970

NPI assigned

Jan 16, 2008

Last updated

Jan 16, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200441600000",
    "number": "1457537888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CAMBRIDGE DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CAMBRIDGE DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016126",
            "telephone_number": "662-231-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "BARRY",
        "middle_name": "DWAYNE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA3784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Specialty Orthopedic Group of Mississippi PLLC
• Specialty Orthopedic Group of Mississippi PLLC
• Alayna Speck, OT
• Caley O'Callaghan Speck, OTR/L
• Andrea B Spencer, OTR/L
• Benjamin Duke Spencer, FNP-BC
• Jason Martin Spencer, DPT
• Louise Moorefield Spencer, MD
• Kendrick Spight
• Spine & Sports Medicine Center PLLC

• Physical Therapy Assistant in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.