Spencer Ole Moen

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

0101276458 Issued in VA

Practice address

400 Sentara Cir Ste 201a
Williamsburg, VA 23188-5716

Phone

(757) 827-2127

Fax

(757) 827-2255

NPI assigned

Mar 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1962963611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 201A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-827-2127",
            "fax_number": "757-827-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 201A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-827-2127",
            "fax_number": "757-827-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "SPENCER",
        "middle_name": "OLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101276458",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101276458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Marlene Mishler, PHARM.D.
• Jennifer Mishoe, LMT
• Mission Mind Wellness, LLC
• Shawn Anthony Mitchell, DDS
• John Mitrovic, PT SCS ATC CSCS
• Angel Fernando Mogrovejo Fajardo, DDS, MS
• Abdul El Rahman Mohamed
• Sheba Mohsin, M.D.
• Mark A Mollner, FNP-C
• Hannah Mone, LPC

• Pulmonary Disease Physician in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Pulmonary Disease Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.