Individual provider Active NPI

Charla C Spencer, MD

  • Obstetrics & Gynecology Physician
  • Tyler, TX
National Provider Identifier
1700851193
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
L0615 Issued in TX
Practice address
1720 S Beckham Ave Ste 104
Tyler, TX 75701-4464
Phone
(903) 597-2002
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X L0615 TX
Obstetrics Physician 207VX0000X L0615 TX
Obstetrics & Gynecology Physician 207V00000X L0615 TX Primary

Addresses

Primary practice location

1720 S Beckham Ave Ste 104
Tyler, TX 75701-4464

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other identifiers 12

IdentifierTypeStateIssuer
039151802MedicaidTX
752616977026OtherTXTRICARE
75-2616977-136OtherTXTRICARE
8A0740OtherTXBCBS OF TEXAS
7600108OtherTXAETNA
8FL328OtherTXBCBS
039151801MedicaidTX
039151804MedicaidTX
P01572867OtherTXRAIL ROAD MEDICARE
123894OtherTXSUPERIOR CHIPS
039151805MedicaidTX
45-2578435-002OtherTXTRICARE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090422000613 TX Practitioner - Obstetrics/Gynecology 5698732345 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Mississippi School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1720 S Beckham Ave
Tyler, TX 75701-4464

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L0615TXMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Apr 1, 2009 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Dec 1, 2015 Accepting new patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Aug 1, 2018 Accepting new patients
Christus Trinity Clinic Texas Obstetrics & Gynecology CurrentSince Apr 1, 2009 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Dec 1, 2015 Accepting new patients
Tyler Family Circle of Care PastSince Jan 19, 2025 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

1720 S Beckham Ave
Ste 104
Tyler, TX 75701
Phone (903) 597-2002

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

1100 E Lake St
Ste 260
Tyler, TX 75701
Phone (903) 590-5700

733 S Fleishel Ave
Tyler, TX 75701
Phone (903) 597-2002

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: cspencer7348@christushealth.direct-ci.net

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700851193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S BECKHAM AVE STE 104",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014464",
            "telephone_number": "903-597-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "CHARLA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "L0615",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "TX",
            "license": "L0615",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
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            "primary": true
        }
    ],
    "identifiers": [
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        },
        {
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            "identifier": "752616977026",
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        },
        {
            "code": "01",
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        {
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            "issuer": "BCBS OF TEXAS",
            "identifier": "8A0740",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7600108",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8FL328",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039151801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039151804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01572867",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR CHIPS",
            "identifier": "123894",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039151805",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "45-2578435-002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.