NPIMap

Organization Active NPI

Tony Sparks, LLC Dba Hazlehurst Pediatrics

  • Pediatrics Physician
  • Hazlehurst, GA
National Provider Identifier
1114743234
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
TONY SPARKS, LLC DBA HAZLEHURST PEDIATRICS
Practice address
143 S Tallahassee St
Hazlehurst, GA 31539-6466
Phone
(912) 375-3360
Fax
(912) 375-3365
NPI assigned
Nov 25, 2024
Last updated
Nov 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Dr. Tony Lewis Sparks, FNPNPI 1902033780
Title
Ceo
Phone
(404) 821-7687

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

143 S Tallahassee St
Hazlehurst, GA 31539-6466

Mailing address

143 S Tallahassee St
Hazlehurst, GA 31539-6466
Phone (912) 375-3360

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1114743234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396466",
            "telephone_number": "912-375-3360",
            "fax_number": "912-375-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396466",
            "telephone_number": "912-375-3360",
            "fax_number": "912-375-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONY SPARKS, LLC DBA HAZLEHURST PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-821-7687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlehurst, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.