Active NPI
Spencer Evan Threw, D.O.
- Family Medicine Physician
- Mahomet, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036178174
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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
- Carle Foundation Hospital
- St Josephs Hospital
- St Anthonys Hospital
- HCA Florida Pasadena Hospital a Part of HCA Florid
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036178174 | IL | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health, Inc. | Current | Accepting new patients | |
| Affiliated Health Clinics | Family Medicine | Current | 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
- https://fhir4.healow.com/fhir/r4/ADGHAD
- 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.
-
- Family Medicine Physician
- St Petersburg, FL
- NPI 1831632900
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
-
- General Acute Care Hospital
- St Petersburg, FL
- NPI 1427024942
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.