Individual provider Active NPI

Kathleen Ann Spencer, RN

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Poughkeepsie, NY
National Provider Identifier
1962627752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
250166-1 Issued in NY
Practice address
230 North Rd
Poughkeepsie, NY 12601-1328
Phone
(845) 486-3726
Fax
(845) 486-3727
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 250166-1 NY Primary

Addresses

Primary practice location

230 North Rd
Poughkeepsie, NY 12601-1328

Mailing address

31 Van Vlack Rd
Hopewell JCT, NY 12533-5956
Phone (845) 226-5302

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
250166-1NYMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962627752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 VAN VLACK RD",
            "city": "HOPEWELL JCT",
            "state": "NY",
            "postal_code": "125335956",
            "telephone_number": "845-226-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011328",
            "telephone_number": "845-486-3726",
            "fax_number": "845-486-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "250166-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.