Active NPI
Sara Nicole Sparks
- Athletic Trainer
- Pella, IA
National Provider Identifier
1184279325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 108741
- Practice address
- 812 University St
Pella, IA 50219-1902 - Phone
- (877) 462-3687
- NPI assigned
- Aug 5, 2019
- Last updated
- Jun 11, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 108741 | IA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
812 University St
Pella, IA 50219-1902
Mailing address
202 W Steenhoek St Unit B
Prairie City, IA 50228-8812
Phone (712) 210-5167
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982665A | Medicaid | IA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108741 | IA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623369600000",
"number": "1184279325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 W STEENHOEK ST UNIT B",
"city": "PRAIRIE CITY",
"state": "IA",
"postal_code": "502288812",
"telephone_number": "712-210-5167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 UNIVERSITY ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502191902",
"telephone_number": "877-462-3687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "SARA",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-05",
"last_updated": "2021-06-11",
"certification_date": "2021-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "108741",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1982665A",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pella, IA
- Sincera Health PLLC (Sincera Urgent Care)
- Sleep & Medical Supply Inc
- Alison Jean Smith, D.O.
- Ryle J Smith, DC
- Mindy Baccam Southammavong, PA-C
- Madison Paige Staley
- Linda Steimling, PA-C
- Sara Stelpflug, M.A.
- Sterling Orthopaedic & Sports Physical Therapy, P.C. (Sterling Physical Therapy, P.C.)
- Hollee Stover Nelson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.