Individual provider Active NPI

Spencer Elmer, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Des Moines, IA
National Provider Identifier
1750156741
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G177086 Issued in IA
Practice address
5550 Wild Rose LN Ste 400
West Des Moines, IA 50266-5351
Phone
(515) 321-4259
Fax
(515) 384-0151
NPI assigned
Nov 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G177086 IA Primary

Addresses

Primary practice location

5550 Wild Rose LN Ste 400
West Des Moines, IA 50266-5351

Mailing address

1090 1St PL
Waukee, IA 50263-9576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104003212 IA Practitioner - Nurse Practitioner 3476904392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G177086IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs Midwest Behavioral Health LLC CurrentSince May 11, 2025 Accepting new patients
KDP Management Services PLLC CurrentSince Nov 14, 2023 Accepting new patients

Locations

1450 NW 114th St
Clive, IA 50325
Phone (515) 553-6200

475 S 50th St
Ste 600
West Des Moines, IA 50265
Phone (319) 531-6000

Organizations & group practices 2

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1750156741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 1ST PL",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502639576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 WILD ROSE LN STE 400",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665351",
            "telephone_number": "515-321-4259",
            "fax_number": "515-384-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMER",
        "first_name": "SPENCER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-20",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G177086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.