Individual provider Active NPI

Robyn Dawn Spencer, ARNP

  • Critical Care Neonatal Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1639363237
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
69103 Issued in OK
Practice address
1120 S Utica Ave
Suite 2123
Tulsa, OK 74104-4012
Phone
(918) 579-5402
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 69103 OK Primary

Addresses

Primary practice location

1120 S Utica Ave
Suite 2123
Tulsa, OK 74104-4012

Mailing address

1120 S Utica Ave
Suite 2123
Tulsa, OK 74104-4012
Phone (918) 579-5402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20181009002457 OK Practitioner - Nurse Practitioner 2062764632 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
69103OKMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Sep 10, 2018 Accepting new patients

Locations

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

Interoperability endpoints

  • Direct secure messaging: robyn.spencer@direct.stjohnhealthsystem.com

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1639363237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "address_2": "SUITE 2123",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-579-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "address_2": "SUITE 2123",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-579-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "ROBYN",
        "middle_name": "DAWN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OK",
            "license": "69103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.