Individual provider Active NPI

Spencer Frederic McNairy, PT, DPT

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1588425672
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305384 Issued in CA
Practice address
1 Embarcadero Ctr
San Francisco, CA 94111-3628
Phone
(415) 799-3300
NPI assigned
Jan 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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 305384 CA Primary

Addresses

Primary practice location

1 Embarcadero Ctr
San Francisco, CA 94111-3628

Mailing address

20185 Harrington Dr
Sonoma, CA 95476-7526
Phone (707) 337-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509000874 CA Practitioner - Physical Therapist in Private Practice 8729429618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305384CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bluejacket Wellness, Inc. Physical Therapist CurrentSince Jan 21, 2024 Accepting new patients

Locations

1 Embarcadero Ctr
San Francisco, CA 94111
Phone (415) 392-2225

1 Embarcadero Ctr
Lbby
San Francisco, CA 94111
Phone (415) 421-4772

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.

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1588425672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20185 HARRINGTON DR",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767526",
            "telephone_number": "707-337-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628",
            "telephone_number": "415-799-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAIRY",
        "first_name": "SPENCER",
        "middle_name": "FREDERIC",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.