Individual provider Active NPI

Cheryl Sparks, ANP

  • Family Nurse Practitioner
  • Amsterdam, NY
National Provider Identifier
1184727653
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F3034691 Issued in NY
Practice address
4988 State Highway 30
Amsterdam Memorial Health Center
Amsterdam, NY 12010-7520
Phone
(518) 843-4356
Fax
(518) 843-6513
NPI assigned
Sep 7, 2006
Last updated
Jun 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F3034691 NY Primary

Addresses

Primary practice location

4988 State Highway 30
Amsterdam Memorial Health Center
Amsterdam, NY 12010-7520

Mailing address

4988 State Highway 30
Amsterdam Memorial Health Center
Amsterdam, NY 12010-7520
Phone (518) 843-4356

Other identifiers 5

IdentifierTypeStateIssuer
547811OtherBLUE CHOICE
10001883OtherCDPHP
08230OtherMVP
01170667MedicaidNY
000401398001OtherDSNENY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091228000174 NY Practitioner - Nurse Practitioner 3375683212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3034691NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael M. Sheridan,D.O. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1184727653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4988 STATE HIGHWAY 30",
            "address_2": "AMSTERDAM MEMORIAL HEALTH CENTER",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-843-4356",
            "fax_number": "518-843-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4988 STATE HIGHWAY 30",
            "address_2": "AMSTERDAM MEMORIAL HEALTH CENTER",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-843-4356",
            "fax_number": "518-843-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "CHERYL",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F3034691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "547811",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10001883",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "08230",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01170667",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSNENY",
            "identifier": "000401398001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.