Individual provider Active NPI

Spencer Geyer Williams, DC

  • Chiropractor
  • Twin Falls, ID
National Provider Identifier
1992863393
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
C-377 Issued in ID
Practice address
392 Falls Ave
Twin Falls, ID 83301-3373
Phone
(208) 734-0500
Fax
(208) 734-0501
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X C-377 ID Primary

Addresses

Primary practice location

392 Falls Ave
Twin Falls, ID 83301-3373

Mailing address

392 Falls Ave
Twin Falls, ID 83301-3373
Phone (208) 734-0500

Other identifiers 5

IdentifierTypeStateIssuer
000010007911OtherIDBLUE SHIELD
350043555OtherIDRAILROAD MEDICARE
381928OtherIDKANSAS BC BS
C-377OtherIDSTATE LICENSE
C7770 8E522OtherIDBLUE CROSS

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

State licenses

LicenseStateTypeSpecialty
C-377IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Potential PLLC Chiropractor PastSince Sep 1, 1998 Accepting new patients
Clear Source Therapy and Clinical Resource Center LLC PastSince May 8, 2022 Accepting new patients

Organizations & group practices 2

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1992863393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013373",
            "telephone_number": "208-734-0500",
            "fax_number": "208-734-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013373",
            "telephone_number": "208-734-0500",
            "fax_number": "208-734-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SPENCER",
        "middle_name": "GEYER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "C-377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010007911",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350043555",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS BC BS",
            "identifier": "381928",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C-377",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C7770 8E522",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.