Ali C Spencer, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

104.0104553 Issued in VT

Practice address

271 Moulton Rd
Waitsfield, VT 05673-7070

Phone

(802) 496-6344

NPI assigned

Jun 4, 2014

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Poulin Performance, Inc.

  • Physical Therapist
  • South Burlington, VT
  • NPI 1174553283
  NPD (past)
• VTPT, Inc.

  • Physical Therapist
  • Waitsfield, VT
  • NPI 1114188356
  NPD (past)

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403308800000",
    "number": "1740693134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 MOULTON RD",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056737070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 MOULTON RD",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056737070",
            "telephone_number": "802-496-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "ALI",
        "middle_name": "C",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104.0104553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Silverberg, LMHC
• Hannah Ruth Skalecke, MPT
• Steven Skalecke, MPT
• Small Dog Electronics Inc.
• Nancy Marie Smyth, MOT/OTR/L
• Elizabeth Cheston Stevenson, M.T.S
• The Drug Store Inc
• Victoria Trihy, MS
• True North Wilderness Programs LLC
• Valley Dental Associates

• All providers in Waitsfield, VT
• Athletic Trainer in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.