Dale A Spence, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2430 Issued in CO

Practice address

Evans Army Comunity Hospital
Premier Medical Home
Ft Carson, CO 80913-4604

Phone

(719) 524-7601

Fax

(719) 524-3526

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1750441440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMUNITY HOSPITAL (EACH) USA",
            "address_2": "1650 COCHRANE CIR ATTN CREDENTIALS OFFICE",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7844",
            "fax_number": "719-526-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMUNITY HOSPITAL",
            "address_2": "PREMIER MEDICAL HOME",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-524-7601",
            "fax_number": "719-524-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "DALE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01722",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Brown Somma, PA-C
• Young-Hee Song, ANP, CHN-CNS
• Mario Soto, M.D.
• Alicia Ruth Souvignier, PT
• Sean Michael Spanbauer
• Steven L. Spoonemore Jr., PT
• Leslie Karen Spry, PHARM.D., MBA
• Melissa Spurling, PHARM.D.
• Claire Janet Squires, DVM
• Veasna Thel Srey, D.P.M.

• Medical Physician Assistant in Ft Carson, CO
• Providers in Ft Carson, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.