DR. SPENCER LEWIS MORTENSEN (NPI# 1568716744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568716744 |
Entity Type | Individual |
Full Name | DR. SPENCER LEWIS MORTENSEN |
Credential | D.P.M |
Practice Address |
1500 Dodson Ave Ste 260 Fort Smith AR 72901-5179 |
Mailing Address |
11001 Executive Center Dr Ste 200 Little Rock AR 72211-4393 |
Practice Telephone | 4795737905 |
Practice Fax Number | 4795737906 |
Mailing Telephone | 5018127215 |
Mailing Fax Number | 5018127207 |
Enumeration Date | 2012-11-09 |
Last Update Date | 2018-12-18 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
5587758-0501 | UT | Podiatric Medicine & Surgery Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548321078 | Spencer David Mortensen | Optometrist | 462 E 100 S, Salt Lake City, UT 84111-1802 | 2006-12-12 |
Street Address |
1500 DODSON AVE STE 260 |
City | FORT SMITH |
State | AR |
Zip Code | 72901-5179 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922587690 | Baptist Health Services | Podiatrist | 1500 Dodson Ave Ste 260, Fort Smith, AR 72901 | 2018-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922627249 | Vaibhav S Desai | Student in an Organized Health Care Education/Training Program | Family Medicine Uams-west, 612 South 12th St., Fort Smith, AR 72901 | 2020-04-16 |
1689136475 | Prudence Nassem Ipaye-adebiyi | Student in an Organized Health Care Education/Training Program | Family Medicine ; Uams-west, 612 South 12th St., Fort Smith, AR 72901 | 2019-04-02 |
1134608961 | Baptist Health Services | Otolaryngology | 520 Towson Ave, Suite A, Fort Smith, AR 72901 | 2018-08-13 |
1316426125 | Baptist Health Services | Internal Medicine | 1500 Dodson Ave Ste 60, Fort Smith, AR 72901 | 2018-08-13 |
1396224101 | Baptist Health Services | Internal Medicine | 1001 Towson Ave Ste 100, Fort Smith, AR 72901 | 2018-08-13 |
1164901914 | Baptist Health Services | Internal Medicine | 1001 Towson Ave Ste 200, Fort Smith, AR 72901 | 2018-08-13 |
1942789755 | Baptist Health Services | Counselor | 1001 Towson Ave Ste 500, Fort Smith, AR 72901 | 2018-08-13 |
1669951315 | Baptist Health Services | Family Medicine | 1500 Dodson Ave Ste 175, Fort Smith, AR 72901 | 2018-08-13 |
1508345265 | Baptist Health Services | Internal Medicine | 1500 Dodson Ave Ste 180, Fort Smith, AR 72901 | 2018-08-13 |
1326527086 | Baptist Health Services | Family Medicine | 1500 Dodson Ave Ste 195, Fort Smith, AR 72901 | 2018-08-13 |
Find all providers in zip 72901 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295743557 | Crotty Foot Clinic P A | Podiatrist | 6600 Rogers Ave, Fort Smith, AR 72903-4064 | 2006-08-03 |
1922587690 | Baptist Health Services | Podiatrist | 1500 Dodson Ave Ste 260, Fort Smith, AR 72901 | 2018-08-13 |
1396808473 | Jason L Seiter | Podiatrist | 1500 Dodson Ave, Ste 290, Fort Smith, AR 72901-5182 | 2006-12-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649791369 | Kyle Haverstrom | Podiatrist | 200 S 20th St Ste B, Rogers, AR 72758-1100 | 2017-07-03 |
1609288984 | Aaron Teufel | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703 | 2014-05-21 |
1982968574 | Adam Lloyd Bingham | Podiatrist | 1713 W Main St, Russellville, AR 72801-2721 | 2012-06-27 |
1477881092 | Bradley Footcare LLC | Podiatrist | 116 W Tyler Ave Ste B, West Memphis, AR 72301-4221 | 2009-11-19 |
1114160389 | Jesse H. Bradley Jr. | Podiatrist | 116 W Tyler Ave, Suite B, West Memphis, AR 72301-4221 | 2009-04-16 |
1154571495 | Mid-south Foot & Ankle Clinic P C | Podiatrist | 302 S Rhodes St, West Memphis, AR 72301-4215 | 2008-09-23 |
1235314147 | Stephanie A. Roth | Podiatrist | 703 W Main St, Russellville, AR 72801-3616 | 2008-01-09 |
1144341827 | Carlotta Monique Wells | Podiatrist | 1132 Malvern Ave, Hot Springs, AR 71901-6347 | 2007-04-02 |
1407936388 | Angela Lorraine Ayson | Podiatrist | 11 Halsted Cir Ste E, Rogers, AR 72756-3145 | 2006-10-16 |
1104842814 | Joseph M. Lacava | Podiatrist | 3339 Central Ave, Suite F, Hot Springs, AR 71913-6138 | 2006-07-14 |
Find all providers with the same taxonomy |
City | FORT SMITH |
Zip Code | 72901 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.