Individual provider Active NPI

Kay Spencer, RN

  • Registered Nurse
  • Jackson, MI
National Provider Identifier
1912494642
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704114371 Issued in MI
Practice address
3369 Miles Rd
Jackson, MI 49201-8707
Phone
(517) 962-4861
Fax
(517) 962-4596
NPI assigned
Apr 18, 2018
Last updated
Apr 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704114371 MI Primary

Addresses

Primary practice location

3369 Miles Rd
Jackson, MI 49201-8707

Mailing address

3369 Miles Rd
Jackson, MI 49201-8707
Phone (517) 962-4861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704114371MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1912494642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3369 MILES RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018707",
            "telephone_number": "517-962-4861",
            "fax_number": "517-962-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3369 MILES RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018707",
            "telephone_number": "517-962-4861",
            "fax_number": "517-962-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "KAY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704114371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.