Mia Lekendra Peterson Spencer, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Practice address

105 Mark Dr
Edenton, NC 27932-1704

Phone

(252) 482-3047

NPI assigned

Nov 1, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in NC

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpetersonspencer20682@direct.ecuhealth.com

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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD
• Moye Medical Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Greenville, NC
  • NPI 1508041666
  NPD (past)

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1811176357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARK DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321704",
            "telephone_number": "252-482-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARK DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321704",
            "telephone_number": "252-482-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON SPENCER",
        "first_name": "MIA",
        "middle_name": "LEKENDRA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naveen Kumar Palapogu, PT
• Matthew Linus Parker, NP
• Jalisa B. Parrish, DDS
• John Christopher Perry, M.D.
• Julia Mills Perry, LCSW
• Heather Elysia Pfahlert, P.A.
• John Meredith Plunkett
• Rachel'S House
• Elizabeth Dawn Reed, LISW-S
• Joanna Reed, LCMHC-A

• Family Nurse Practitioner in Edenton, NC
• Providers in Edenton, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.

Verify at the official NPI Registry.