Individual provider Active NPI

Eric A Spencer, MD

  • Emergency Medicine Physician
  • Springfield, OR
National Provider Identifier
1568417574
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD24765 Issued in OR
Practice address
1460 G St
Springfield, OR 97477-4112
Phone
(541) 726-4400
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X MD24765 OR
Emergency Medicine Physician 207P00000X MD24765 OR Primary

Addresses

Primary practice location

1460 G St
Springfield, OR 97477-4112

Mailing address

PO Box 825
Springfield, OR 97477-0141
Phone (547) 343-5772

Other identifiers 1

IdentifierTypeStateIssuer
297548MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040422000007 OR Practitioner - Emergency Medicine 4587659230 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24765ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Emergency Room Corp PC Emergency Medicine CurrentSince Jun 1, 2012 Accepting new patients
Icco LLC PastSince Aug 28, 2018 Accepting new patients
Eric a Spencer MD PC Emergency Medicine PastSince Jan 15, 2004 Accepting new patients

Locations

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

Interoperability endpoints

  • Direct secure messaging: espenc01@yourcarecommunity.org
  • FHIR API: https://api.platform.athenahealth.com/1804/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1568417574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974770141",
            "telephone_number": "547-343-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774112",
            "telephone_number": "541-726-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "ERIC",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "OR",
            "license": "MD24765",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD24765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297548",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.