Active NPI
Candace Rae Sparks, P.T.
- Physical Therapist
- Memphis, TN
National Provider Identifier
1013296607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9038
- Practice address
- 6286 Briarcrest Ave
Suite 110
Memphis, TN 38120-4023 - Phone
- (901) 259-1600
- Fax
- (901) 259-1698
- NPI assigned
- Aug 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9038 | TN | Primary |
Addresses
Primary practice location
6286 Briarcrest Ave
Suite 110
Memphis, TN 38120-4023
Mailing address
PO Box 8888
Belfast, ME 04915-8888
Phone (901) 259-4260
Other names 1
- Candace Rae Halvorson
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9038 | TN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MSK Group PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392768000000",
"number": "1013296607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8888",
"city": "BELFAST",
"state": "ME",
"postal_code": "049158888",
"telephone_number": "901-259-4260",
"fax_number": "901-259-2785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6286 BRIARCREST AVE",
"address_2": "SUITE 110",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381204023",
"telephone_number": "901-259-1600",
"fax_number": "901-259-1698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "CANDACE",
"middle_name": "RAE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-12",
"last_updated": "2014-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "9038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CANDACE",
"last_name": "HALVORSON",
"middle_name": "RAE",
"credential": "P.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.