Spencer Todd, PT, DPT. OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-5892 Issued in HI

Practice address

73-5590 Kauhola St Ste a
Kailua Kona, HI 96740-2610

Phone

(808) 329-7744

Fax

(808) 334-1608

NPI assigned

Oct 14, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Club Rehab, Inc.

  • Physical Therapy Clinic/Center
  • Kailua Kona, HI
  • NPI 1811092406

  Physical Therapist

  NPD

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1548986235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73-5590 KAUHOLA ST STE A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402610",
            "telephone_number": "808-329-7744",
            "fax_number": "808-334-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73-5590 KAUHOLA ST STE A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402610",
            "telephone_number": "808-329-7744",
            "fax_number": "808-334-1608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 N Edgemont St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900275209",
            "country_code": "US",
            "telephone_number": "800-954-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "SPENCER",
        "credential": "PT, DPT. OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-14",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Brunson Tieri, PT
• TLC Chiropractic, LLC
• Emily To
• Toby L Smith DO
• Shianne Eryka Todd, RN, BSN
• Ivan Edward Toguchi, D.D.S
• Nathan P Tomita, D.O.
• Benjammin Totten
• Kelli Jean Totten, RBT
• Transformation Health Network

• Physical Therapist in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.