Individual provider Active NPI

Isaac Paul Spencer, DPT

  • Physical Therapist
  • Kodiak, AK
National Provider Identifier
1578237574
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
181441 Issued in AK
Practice address
326 Center Ave Ste 100
Kodiak, AK 99615-7302
Phone
(907) 486-4042
NPI assigned
Aug 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 181441 AK Primary

Addresses

Primary practice location

326 Center Ave Ste 100
Kodiak, AK 99615-7302

Mailing address

105 Brampton CT
Winston Salem, NC 27106-4482
Phone (336) 413-9029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
181441AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Chiropractic and Physical Medicine Kodiak CurrentSince Aug 8, 2021 Accepting new patients

Locations

326 Center Ave
Ste 100
Kodiak, AK 99615
Phone (907) 486-4042

Organizations & group practices 1

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1578237574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BRAMPTON CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064482",
            "telephone_number": "336-413-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 CENTER AVE STE 100",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996157302",
            "telephone_number": "907-486-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "ISAAC",
        "middle_name": "PAUL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "181441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kodiak, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.