Individual provider Active NPI

Richard Glenn Spencer, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1962536706
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0042757 Issued in MD
Practice address
5600 Nathan Shock Dr
GRC 4D-08
Baltimore, MD 21224-6825
Phone
(410) 558-8226
Fax
(410) 558-8318
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0042757 MD Primary

Addresses

Primary practice location

5600 Nathan Shock Dr
GRC 4D-08
Baltimore, MD 21224-6825

Mailing address

503 Fairway CT
Towson, MD 21286-7338
Phone (410) 558-8226

Other identifiers 1

IdentifierTypeStateIssuer
183011200MedicaidMD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0042757MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of Maryland, P.C. Past Accepting new patients
Dimensions Health Corporation Past Accepting new patients
Contee Emergency Physicians Past Accepting new patients
Atlantic Physician Services of Maryland, PC Past Accepting new patients
Medlantic Healthcare Group Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1962536706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 FAIRWAY CT",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212867338",
            "telephone_number": "410-558-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 NATHAN SHOCK DR",
            "address_2": "GRC 4D-08",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212246825",
            "telephone_number": "410-558-8226",
            "fax_number": "410-558-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "RICHARD",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0042757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183011200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.