Sidney Rebecca Spencer, DO

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

58.033043 Issued in OH

Practice address

8401 Market St
Boardman, OH 44512-6725

Phone

(417) 770-4206

NPI assigned

Apr 19, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: sspencer1243075@direct.bsmhealth.org
• Direct secure messaging: sspencer554313@ehrdirect.uhhospitals.org

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1699418491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MORGAN DR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011578",
            "telephone_number": "417-770-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126725",
            "telephone_number": "417-770-4206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Morgan Dr",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648011578",
            "country_code": "US",
            "telephone_number": "417-770-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "SIDNEY",
        "middle_name": "REBECCA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "58.033043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandon St Clair
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• Otolaryngology Physician in Boardman, OH
• Providers in Boardman, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.