NPIMap

Organization Active NPI

Sparks Medical Foundation

Doing business as RC Goodman Institue for Pain

  • Durable Medical Equipment & Medical Supplies
  • Fort Smith, AR
National Provider Identifier
1063519460
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SPARKS MEDICAL FOUNDATION
Doing business as
RC Goodman Institue for Pain
Practice address
1500 Dodson Ave
Ste 65
Fort Smith, AR 72901-5182
Phone
(479) 441-5475
Fax
(479) 441-4803
NPI assigned
Sep 20, 2006
Last updated
Nov 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rebecca Friddle
Title
Sparks Provider Relations Manager
Phone
(479) 709-7057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X AR Primary

Addresses

Primary practice location

1500 Dodson Ave
Ste 65
Fort Smith, AR 72901-5182

Mailing address

PO Box 1824
Fort Smith, AR 72902-1824
Phone (479) 709-7399

Other identifiers 1

IdentifierTypeStateIssuer
4454530047OtherARM-CARE DME

Other names 1

  • RC Goodman Institue for Pain Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sparks Medical Foundation36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1063519460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729021824",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DODSON AVE",
            "address_2": "STE 65",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015182",
            "telephone_number": "479-441-5475",
            "fax_number": "479-441-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "FRIDDLE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SPARKS PROVIDER RELATIONS MANAGER",
        "authorized_official_telephone_number": "479-709-7057"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE DME",
            "identifier": "4454530047",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RC Goodman Institue for Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.