Individual provider Active NPI

Nancy Lynn Spencer, MSN FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1487657052
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Practice address
9155 SW Barnes Rd
Ste 740
Portland, OR 97225-6634
Phone
(503) 297-7403
Fax
(503) 297-3096
NPI assigned
May 27, 2005
Reactivated
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd
Ste 740
Portland, OR 97225-6634

Mailing address

19643 SW Bernhardt Drive
Aloha, OR 97007
Phone (503) 494-9000

Other identifiers 1

IdentifierTypeStateIssuer
275173MedicaidOR

Other names 1

  • Nancy Lynn Reed Former name

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
200350124NPORMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1487657052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19643 SW BERNHARDT DRIVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "97007",
            "telephone_number": "503-494-9000",
            "fax_number": "503-494-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "STE 740",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256634",
            "telephone_number": "503-297-7403",
            "fax_number": "503-297-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MSN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-10-02",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275173",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "REED",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.