Individual provider Active NPI

Spencer Evan Threw, D.O.

  • Family Medicine Physician
  • Mahomet, IL
National Provider Identifier
1548795222
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036178174 Issued in IL
Practice address
1001 Heather Dr
Mahomet, IL 61853-2754
Phone
(217) 586-8400
NPI assigned
May 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036178174 IL Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 036178174 IL

Addresses

Primary practice location

1001 Heather Dr
Mahomet, IL 61853-2754

Mailing address

306 Beringer Cir
Urbana, IL 61802-2276
Phone (727) 322-4227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220308003043 FL Practitioner - Family PracticePractitioner - Sports Medicine 0446661797 Reassigns benefits to 1 organization
I20260330000112 IL Practitioner - Family Practice 0446661797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Affiliated Health ClinicsGroup PAC ID 6305129693, 6 clinicians

Practice addresses (Care Compare)

1001 Heather Dr
Mahomet, IL 61853-2754
Phone (217) 586-8444

1515 22ND Ave N
St Petersburg, FL 33704-3113
Phone (727) 322-4227

2300 S 1St St
Champaign, IL 61820-7661
Phone (217) 383-9400

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036178174ILMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Affiliated Health Clinics Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1515 22nd Ave N
St Petersburg, FL 33704
Phone (727) 322-4227

3600 Central Ave
St Petersburg, FL 33711
Phone (727) 322-4227

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADGHAD
  • Direct secure messaging: sthrew361536@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1548795222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 BERINGER CIR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618022276",
            "telephone_number": "727-322-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HEATHER DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618532754",
            "telephone_number": "217-586-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THREW",
        "first_name": "SPENCER",
        "middle_name": "EVAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036178174",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036178174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahomet, IL

Sources for this page

Verify at the official NPI Registry.