Spencer Craig Despain, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60754 Issued in OR

Practice address

2519 Cove Ave
La Grande, OR 97850-3910

Phone

(541) 962-0830

Fax

(541) 975-2720

NPI assigned

Nov 19, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1861899858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 COVE AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503910",
            "telephone_number": "541-962-0830",
            "fax_number": "541-975-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 COVE AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503910",
            "telephone_number": "541-962-0830",
            "fax_number": "541-975-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPAIN",
        "first_name": "SPENCER",
        "middle_name": "CRAIG",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Davis, DO
• Troy Davis
• Alisha Delatori
• Michael Glenn Dempsey, R.PH.
• Gregg S Densmore, M.D.
• Katherine Dewey, MA, CCC-SLP
• Bryan Dewitt, CRM
• Jessica Diaz, CRM
• Jamie Rose Dickenson, LCSW
• Amber Diederich, CADC I, CRM

• Physical Therapist in La Grande, OR
• Providers in La Grande, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.