Individual provider Active NPI

Avery Spencer

  • Family Nurse Practitioner
  • Fitchburg, WI
National Provider Identifier
1568056794
Registry record updated Nov 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10497-33 Issued in WI
Practice address
3051 Cahill Main
Fitchburg, WI 53711-7109
Phone
(608) 661-7200
NPI assigned
Feb 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2022

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 10497-33 WI Primary

Addresses

Primary practice location

3051 Cahill Main
Fitchburg, WI 53711-7109

Mailing address

397 N Bergamont Blvd
Oregon, WI 53575-3715
Phone (608) 843-3498

Other practice location 1

202 S Park St
Madison, WI 53715-1507
Phone (608) 843-3498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210611000920 WI Practitioner - Nurse Practitioner 4486054525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

3051 Cahill Main
Fitchburg, WI 53711-7109
Phone (608) 661-7200

5249 E Terrace Dr
Madison, WI 53718-8339
Phone (608) 222-9777

675 W Washington Ave
Madison, WI 53703-2637
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10497-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Jan 24, 2022 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

3051 Cahill Main
Fitchburg, WI 53711
Phone (608) 257-9700

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

1265 John Q Hammons Dr
Madison, WI 53717

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

Organizations & group practices 2

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 1

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": "1614470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667606400000",
    "number": "1568056794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 N BERGAMONT BLVD",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753715",
            "telephone_number": "608-843-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 CAHILL MAIN",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117109",
            "telephone_number": "608-661-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151507",
            "country_code": "US",
            "telephone_number": "608-843-3498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "AVERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-28",
        "last_updated": "2022-11-05",
        "certification_date": "2022-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10497-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.