NPIMap

Individual provider Active NPI

Mark D Spencer, MD

  • Family Medicine Physician
  • Wendell, ID
National Provider Identifier
1497719728
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M4484 Issued in ID
Practice address
410 N Idaho St
Wendell, ID 83355-5038
Phone
(208) 990-3226
Fax
(888) 440-7959
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M4484 ID Primary

Addresses

Primary practice location

410 N Idaho St
Wendell, ID 83355-5038

Mailing address

PO Box 447
Gooding, ID 83330
Phone (208) 934-5900

Other practice location 1

410 N Idaho St
Wendell, ID 83355-5038
Phone (208) 536-3995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120322000523 ID Practitioner - Family Practice 5799945150 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1979
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

537 E Forest Ridge Dr
Meridian, ID 83642-4657

PO Box
Suite 447
Gooding, ID 83330

Hospital & facility affiliations

  • Idaho Home Health & Hospice Home health agency, Twin Falls, ID, CCN 137014
  • Visions Home Health & Visions Home Care LLC Home health agency, Twin Falls, ID, CCN 137107
  • North Canyon Medical Center Hospital, Gooding, ID, CCN 131302
  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Jerome Hospital, Jerome, ID, CCN 131310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M4484IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Family Practice Inc Family Medicine CurrentSince Jun 2, 2003 Accepting new patients
Associates in Family Practice Inc Family Medicine Current Accepting new patients
Precision Medical Care LLC Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Associates in Family Practice Inc Family Medicine CurrentSince Jun 2, 2003 Accepting new patients
Wendell Family Medicine, LLC Family Medicine PastSince Mar 11, 2025 Accepting new patients

Locations

425 Idaho St
Gooding, ID 83330
Phone (208) 934-5900

640 Frogs Lndg
Hagerman, ID 83332
Phone (208) 731-6241

3155 Channing Way
Idaho Falls, ID 83404
Phone (801) 699-6344

2965 E Tarpon Dr
Ste 110
Meridian, ID 83642
Phone (208) 617-6455

410 N Idaho St
Wendell, ID 83355
Phone (208) 536-3995

1633 W Innovation Way
Fl 5
Lehi, UT 84043
Phone (801) 699-6344

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Canyon Medical CenterGooding, ID, CCN 131302 Hospital Corporate Officer Mar 25, 2014
North Canyon Family MedicineGooding, ID, CCN 138520 Rural health clinic Corporate Officer Mar 25, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 5

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1497719728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "83330",
            "telephone_number": "208-934-5900",
            "fax_number": "208-934-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N IDAHO ST",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833555038",
            "telephone_number": "208-990-3226",
            "fax_number": "888-440-7959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 N Idaho St",
            "address_purpose": "LOCATION",
            "city": "Wendell",
            "state": "ID",
            "postal_code": "833555038",
            "country_code": "US",
            "telephone_number": "208-536-3995",
            "fax_number": "888-440-7959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M4484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wendell, ID

Sources for this page

Verify at the official NPI Registry.