ELIZABETH A SPENCERI (NPI# 1588665509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588665509 |
| Entity Type | Individual |
| Full Name | ELIZABETH A SPENCERI |
| Credential | MD |
| Practice Address |
11550 Granada St Leawood KS 66211-1453 |
| Practice Telephone | (913) 451-7546 |
| Practice Fax Number | 9136632411 |
| Mailing Telephone | (913) 451-7546 |
| Mailing Fax Number | 9136632411 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2017-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 30619 | KS | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
30619 | KS | Allopathic & Osteopathic Physicians |
| Street Address |
11550 GRANADA ST |
| City | LEAWOOD |
| State | KS |
| Zip Code | 66211-1453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750655585 | Anne M Blake | Dermatology | 11550 Granada St, Leawood, KS 66211-1453 | 2012-02-24 |
| 1174722292 | Colin A Ruff | Dermatology | 11550 Granada St, Leawood, KS 66211-1453 | 2007-07-18 |
| 1568669794 | Celeste A Angel | Dermatology | 11550 Granada St, Leawood, KS 66211-1453 | 2007-06-29 |
| 1669577524 | Skin & Mohs Surgery Center, LLC | Clinic/Center | 11550 Granada St, Leawood, KS 66211-1453 | 2006-09-14 |
| 1326090259 | Daniel P Bortnick | Plastic Surgery | 11550 Granada St, Leawood, KS 66211-1453 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427002575 | Shawn R Sabin | Dermatology | 11550 Granada Ln, Leawood, KS 66211-1453 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326484999 | Kevin R Brough | Dermatology | 1861 N Rock Rd Ste 205, Wichita, KS 67206-1264 | 2013-05-22 |
| 1740260868 | Joseph E. Gadzia | Dermatology | 2921 Sw Wanamaker Dr, Topeka, KS 66614-5334 | 2006-01-17 |
| 1487659959 | Timothy L Parker | Dermatology | 6901 W 121st St, Overland Park, KS 66209-2007 | 2005-06-20 |
| 1124094867 | Advanced Dermatology and Skin Cancer Center, Pa | Dermatology | 2735 Pembrook Pl, Manhattan, KS 66502-7482 | 2006-02-23 |
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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.