Shawanda Lester Spencer, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5008617 Issued in NC

Practice address

12830 Walker Branch Rd
Charlotte, NC 28273-8850

Phone

(704) 583-2601

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shawanda.spencer.1@12412.direct.athenahealth.com

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.

• Integrated Wound Specialists of North Carolina, PLLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Pinehurst, NC
  • NPI 1558666776
  Medicare reassignment NPD
• Prosper at Home Health Care Services LLC

  dba Premium Direct Medical

  • Family Nurse Practitioner
  • Waxhaw, NC
  • NPI 1215385463
  NPD Authorized official

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1992154959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7319 YELLOWHORN TRL",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737465",
            "telephone_number": "704-907-0537",
            "fax_number": "888-375-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12830 WALKER BRANCH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282738850",
            "telephone_number": "704-583-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "SHAWANDA",
        "middle_name": "LESTER",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008617",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F0516317",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF NURSING APPROVAL NUMBER",
            "identifier": "5008617",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP CERTIFICATION",
            "identifier": "F0516317",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Spencer
• Ernestine Spencer, LPC
• Gregory Spencer
• Lashawn Spencer
• Shanequa Sheree Spencer, LMFT
• Susan Elizabeth Spencer, PHARMD
• Temeka K. Spencer, RN
• Madison Spencley, BCBA
• Jordan Spennato, DPT
• Marianna Spero, LAT, ATC

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.