Spencer Tietjen, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

Practice address

2245 N 400 E
Ste 301
Logan, UT 84341-1892

Phone

(435) 753-7880

NPI assigned

Mar 11, 2011

Sex

Male

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 UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Cache Valley Ear Nose & Throat, PLLC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • North Logan, UT
  • NPI 1548303795
  Medicare reassignment

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1851699003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 N 400 E",
            "address_2": "STE 301",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411892",
            "telephone_number": "435-753-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 N 400 E",
            "address_2": "STE 301",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411892",
            "telephone_number": "435-753-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2380 N 400 E Ste D",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "UT",
            "postal_code": "843411756",
            "country_code": "US",
            "telephone_number": "435-753-7880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIETJEN",
        "first_name": "SPENCER",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-11",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Jared Thornley, D.D.S.
• Shellie D Thornley, SLP
• Justin Dane Thornton, D.D.S.
• Lindsay Thunell
• Juliet Pack Tietjen, LMFT
• Vickie B Tilley, RN, CDE
• Utaifeau Joseph Tilo
• Dylan Rolland Tingey
• Natalie Tippets
• Deonn C Tolbert, PHARMACIST

• Audiologist in Logan, UT
• Providers in Logan, UT by specialty
• Audiologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.