Spencer John Craven, M.D.
Individual provider Active NPI Neurology Physician · Boise, ID
NPI 1992169452 · NPPES record last updated Jul 12, 2022
Key facts
- NPI
- 1992169452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- M-16665 (ID)
- Practice address
- 1055 N Curtis Rd
Boise, ID 83706-1309 - Phone
- (208) 302-4200
- Fax
- (208) 302-4255
- NPI assigned
- Apr 11, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- University of Rochester School of Medicine and Dentistry, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Alphonsus Regional Medical Center Inc
Practice addresses (Care Compare)
1055 N Curtis
Boise, ID 83706-1309
1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121
3025 W Cherry LN
Meridian, ID 83642-8531
323 E Riverside Dr
Eagle, ID 83616-6865
Phone (208) 302-6000
4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000
Hospital & facility affiliations
- Saint Alphonsus Regional Medical Center
- Saint Alphonsus Medical Center - Nampa
- St. Alphonsus Medical Center - Baker City
- Saint Alphonsus Medical Center Ontario
- Grande Ronde Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220816000783 | ID | Practitioner - Neurology | 1153616230 | Reassigns benefits to 1 organization |
| I20230216001770 | OR | Practitioner - Neurology | 1153616230 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-16665 | ID | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | Current |
Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Neurology | Current | Accepting new patients |
| Saint Alphonsus Regional Medical Center Inc | Neurology | Current |
Accepting new patients |
Locations
1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152
3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342
3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400
3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400
3175 Pocahontas Rd
Baker City, OR 97814
Phone (208) 302-2200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NC | ||
| Neurology Physician | 2084N0400X | M-16665 | ID | Yes |
Addresses
Primary practice location
1055 N Curtis Rd
Boise, ID 83706-1309
Mailing address
3340 E Goldstone Dr
Meridian, ID 83642-1026
Phone (208) 302-9342
Other practice location 1
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (801) 664-4656
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.