Active NPI
Spencer C Wirig, D.M.D.
- Dentist
- Mountain Home a F B, ID
National Provider Identifier
1801948484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D-4020
- Practice address
- 90 Hope Dr
Mountain Home a F B, ID 83648-1057 - Phone
- (208) 828-7300
- NPI assigned
- Jan 17, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | D-4020 | ID | Primary |
Addresses
Primary practice location
90 Hope Dr
Mountain Home a F B, ID 83648-1057
Mailing address
90 Hope Dr
Mountain Home a F B, ID 83648-1057
Phone (208) 828-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150429000860 | ID | Order and Referring Only - Oral Surgery | 5991024705 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4020 | ID | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187827200000",
"number": "1801948484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 HOPE DR",
"city": "MOUNTAIN HOME A F B",
"state": "ID",
"postal_code": "836481057",
"telephone_number": "208-828-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 HOPE DR",
"city": "MOUNTAIN HOME A F B",
"state": "ID",
"postal_code": "836481057",
"telephone_number": "208-828-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIRIG",
"first_name": "SPENCER",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-17",
"last_updated": "2007-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-4020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home a F B, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.