Active NPI
Colleen Kay Spencer, RN, BSN
- Home Health Registered Nurse
- Custer, WI
National Provider Identifier
1730355645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 77124-030
- Practice address
- 185 Edgewood Rd N
Custer, WI 54423-9780 - Phone
- (715) 592-4092
- NPI assigned
- May 1, 2008
- Last updated
- Oct 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 77124-030 | WI | Primary |
Addresses
Primary practice location
185 Edgewood Rd N
Custer, WI 54423-9780
Mailing address
185 Edgewood Rd N
Custer, WI 54423-9780
Phone (715) 592-4092
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35002700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77124-030 | WI | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1730355645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 EDGEWOOD RD N",
"city": "CUSTER",
"state": "WI",
"postal_code": "544239780",
"telephone_number": "715-592-4092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 EDGEWOOD RD N",
"city": "CUSTER",
"state": "WI",
"postal_code": "544239780",
"telephone_number": "715-592-4092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "COLLEEN",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "RN, BSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-01",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "WI",
"license": "77124-030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35002700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Custer, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.