MR. DONAVAN D SPENCER (NPI# 1609803691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609803691 |
| Entity Type | Individual |
| Full Name | MR. DONAVAN D SPENCER |
| Credential | MD |
| Practice Address |
205 South St Fort Bragg CA 95437-5540 |
| Practice Telephone | 7079641251 |
| Mailing Telephone | 7079641251 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | G85455 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G854550 | 05 | |
| CA | BS OF CA | 00G854550 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 510 Cypress St Ste D, Fort Bragg, CA 954375411 | 7079641251 |
| Street Address |
205 SOUTH ST |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508861782 | Wade Joseph Gray | Family Medicine | 205 South St, Fort Bragg, CA 95437-5540 | 2005-06-15 |
| 1477046027 | Roy Campbell | Dental Hygienist | 205 South St, Fort Bragg, CA 95437-5540 | 2018-06-08 |
| 1457861783 | Andrea Masters | Nurse Practitioner | 205 South St, Fort Bragg, CA 95437-5540 | 2017-09-29 |
| 1437501566 | Jae Do Kim | Dentist | 205 South St, Fort Bragg, CA 95437-5540 | 2016-07-13 |
| 1558790774 | Nadege Nerette | Physician Assistant | 205 South St, Fort Bragg, CA 95437-5540 | 2013-11-07 |
| 1932532272 | Svetlana Romanovna Mulcahy | Nurse Practitioner | 205 South St, Fort Bragg, CA 95437-5540 | 2013-08-09 |
| 1013257831 | Kimberly Jill Celeri | Dental Hygienist | 205 South St, Fort Bragg, CA 95437-5540 | 2013-02-15 |
| 1821340480 | Genevieve Marilyn Gonzalez | Counselor | 205 South St, Fort Bragg, CA 95437 | 2012-10-08 |
| 1447500988 | Ted Michael Aames | Counselor | 205 South St, Fort Bragg, CA 95437-5540 | 2012-09-12 |
| 1740587229 | Wendy J Carvajal | Dentist | 205 South St, Fort Bragg, CA 95437-5540 | 2011-02-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306896428 | John A Kermen | Anesthesiology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-11 |
| 1619524675 | Melissa Ouellette | Anesthesiology | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2019-08-23 |
| 1346897303 | Logan Drake Hirsch | Anesthesiology | 2817 Reilly Road, Fort Bragg, NC 28310 | 2019-08-23 |
| 1174170138 | Allison Paige Martin | Anesthesiology | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2019-08-23 |
| 1821645888 | Alyson Anna Ochs | Anesthesiology | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2019-08-23 |
| 1982251054 | Bernard Lease | Anesthesiology | 2817 Reilly Road, Fort Bragg, NC 28310 | 2019-08-22 |
| 1942774344 | Micah Krishnan | Anesthesiology | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2019-01-18 |
| 1841517638 | Samuel Neal Blacker | Anesthesiology | Womack Army Medical Center, Fort Bragg, NC 28310-3017 | 2010-05-03 |
| 1134179302 | John A. Kermen, D.o. | Anesthesiology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-11 |
| 1487632733 | Frederick Victor Palmquist | Anesthesiology | 2817 Reilly Road, Womack Army Cetner Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2006-01-06 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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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.