Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1609803691 Individual Practitioner Male Practitioner

Dr. Donavan D Spencer , MD

Pediatrics • Fort Bragg, CA

Professional Overview & Biography Verified Profile Summary

Dr. Donavan Spencer, MD is a registered healthcare professional specializing in Pediatrics in Fort Bragg, CA. Practice services are available at 205 SOUTH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

205 South St

Fort Bragg, CA 954375540

Telephone 7079641251
Associated Practice Facility / Clinic
🏢 Mendocino Coast Clinics Inc Facility NPI 1083783757

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Fort Bragg, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.5 Yrs
Regional Practice Density
4 Specialists

Practicing in Fort Bragg, CA (9612 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-11-11
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License CA G85455

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License ME MD26431

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
00G854550 (CA)
Commercial Insurance / Payer ID Bs Of Ca
00G854550 (CA)

Secondary Practice Locations

510 Cypress St Ste D

Fort Bragg, CA 954375411

Phone: 7079641251

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Richard Jaulus , LCSW

Social Worker - Clinical

NPI 1013031079

Licensed Clinical Social Worker

Kimberly Celeri , RDH

Dental Hygienist

NPI 1013257831

Registered Dental Hygienist

Dr. John Wallace , MD

Internal Medicine

NPI 1023079803

Doctor of Medicine (M.D.)

Rena Blauner , LCSW

Social Worker - Clinical

NPI 1063537801

Licensed Clinical Social Worker

NPI 1104941160
John Ramirez , LCSW

Social Worker - Clinical

NPI 1144793639

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 11, 2022

Pediatrics (License #MD26431 in ME)

📍
Updated Practice Location February 27, 2019

Registered at 205 SOUTH ST, FORT BRAGG, CA 954375540 (Tel: 7079641251)

📍
Updated Business Mailing Address February 27, 2019

Registered at 205 SOUTH ST, FORT BRAGG, CA 954375540 (Tel: 7079641251)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 465 W PUTNAM AVE, PORTERVILLE, CA 93257 (Tel: 5597841110)

📍
Updated Business Mailing Address July 08, 2007

Registered at PO BOX 7096, STOCKTON, CA 952670096 (Tel: 2099567725)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as DONAVAN SPENCER, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Anesthesiology (License #G85455 in CA)

🟢
Initial NPI Registration & Enumeration June 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1609803691
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 27, 2006
Last Update: November 11, 2022
Sole Proprietor: No

Mailing Address

205 South St

Fort Bragg, CA 954375540

Phone: 7079641251

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.