Active NPI
Jerri Sparks, MCD
- Speech-Language Pathologist
- Jonesboro, AR
National Provider Identifier
1205130390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 1900 Stillwater Dr
Jonesboro, AR 72404-9119 - Phone
- (870) 932-3600
- Fax
- (870) 931-4201
- NPI assigned
- Jan 4, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | AR | Primary |
Addresses
Primary practice location
1900 Stillwater Dr
Jonesboro, AR 72404-9119
Mailing address
4112 Walters Rd
Jonesboro, AR 72404-9026
Phone (870) 377-0323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186685721 | Medicaid | AR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678233600000",
"number": "1205130390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4112 WALTERS RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724049026",
"telephone_number": "870-377-0323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 STILLWATER DR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724049119",
"telephone_number": "870-932-3600",
"fax_number": "870-931-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "JERRI",
"credential": "MCD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-04",
"last_updated": "2023-03-08",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "186685721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.