Kelly Sparks, MACCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2975 Issued in OK

Practice address

4928 Cinderwood Dr
Yukon, OK 73099-2118

Phone

(405) 350-2654

NPI assigned

Apr 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Qualified Speech Language Pathologist

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073732947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4928 CINDERWOOD DR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730992118",
            "telephone_number": "405-350-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4928 CINDERWOOD DR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730992118",
            "telephone_number": "405-350-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "MACCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Sober, LPC
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• Spanish Cove Housing Authority
• Spanish Cove Housing Authority (Spanish Cove at Home)
• Spanish Cove Housing Authority (Spanish Cove Retirement Village)
• Speech by Melissa LLC (Advanced Therapy Solutions)
• Speech Therapy Building Blocks
• Cristy Spencer
• SSM Healthcare of Oklahoma, Inc (St Anthony Cancer Specialists of Oklahoma @ Yukon)
• Melissa Stahlman

• Speech-Language Pathologist in Yukon, OK
• Providers in Yukon, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.