Active NPI
Spenner Dermatology Inc
- Dermatology Physician
- Kirkwood, MO
National Provider Identifier
1578877395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- R1A88
- Legal business name
- SPENNER DERMATOLOGY INC
- Practice address
- 439 S Kirkwood Rd
Suite 206
Kirkwood, MO 63122-6169 - Phone
- (314) 966-2010
- Fax
- (314) 966-4825
- NPI assigned
- Aug 4, 2010
- Last updated
- Sep 16, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Craig William Spenner, M.D.
- Title
- President
- Phone
- (314) 966-2010
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | R1A88 | MO | Primary |
Addresses
Primary practice location
439 S Kirkwood Rd
Suite 206
Kirkwood, MO 63122-6169
Mailing address
439 S Kirkwood Rd
Suite 206
Kirkwood, MO 63122-6169
Phone (314) 966-2010
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154320877 | Other | MO | CRAIG SPENNER M.D. |
| 1154320877 | Other | MO | TYPE 1 NPI |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Dermatology Physician
- Kirkwood, MO
- NPI 1154320877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280880000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1284595200000",
"number": "1578877395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "439 S KIRKWOOD RD",
"address_2": "SUITE 206",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631226169",
"telephone_number": "314-966-2010",
"fax_number": "314-966-4825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "439 S KIRKWOOD RD",
"address_2": "SUITE 206",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631226169",
"telephone_number": "314-966-2010",
"fax_number": "314-966-4825"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPENNER DERMATOLOGY INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-04",
"last_updated": "2010-09-16",
"status": "A",
"authorized_official_last_name": "SPENNER",
"authorized_official_first_name": "CRAIG",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "314-966-2010",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MO",
"license": "R1A88",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRAIG SPENNER M.D.",
"identifier": "1154320877",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TYPE 1 NPI",
"identifier": "1154320877",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirkwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.