Individual provider Active NPI

Erin Victoria Sparks, M.D.

  • Neurology Physician
  • Charleston, SC
National Provider Identifier
1164733366
Registry record updated Feb 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
32924 Issued in SC
Practice address
2097 Henry Tecklenburg Dr
Suite 322W
Charleston, SC 29414-5740
Phone
(843) 402-5035
Fax
(843) 402-5036
NPI assigned
Jun 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 32924 SC Primary

Addresses

Primary practice location

2097 Henry Tecklenburg Dr
Suite 322W
Charleston, SC 29414-5740

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other identifiers 1

IdentifierTypeStateIssuer
329246MedicaidSC

Other names 1

  • Dr. Erin Victoria Ilkanich Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141209000822 SC Practitioner - Neurology 8820310535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, shared by 11 NPIs, 504 clinicians

Practice addresses (Care Compare)

979 E 3Rd St
Suite C830
Chattanooga, TN 37403-3325
Phone (423) 778-9001

Hospital & facility affiliations

  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Sep 30, 2014 Accepting new patients
University Medical Associates of the Medical University of South Carol Neurology CurrentSince Nov 12, 2015 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Sep 30, 2014 Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

2097 Henry Tecklenburg Dr
Ste 322W
Charleston, SC 29414
Phone (843) 402-5035

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423267200000",
    "number": "1164733366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 HENRY TECKLENBURG DR",
            "address_2": "SUITE 322W",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145740",
            "telephone_number": "843-402-5035",
            "fax_number": "843-402-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "ERIN",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2015-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "32924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329246",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "ILKANICH",
            "middle_name": "VICTORIA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.