Samantha Jo Sparks, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71011714A Issued in IN

Practice address

1373 E State Road 62
Madison, IN 47250-7328

Phone

(812) 801-0800

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Mental Health Center Inc.Group PAC ID 1456330166, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Mental Health Center Inc

  dba INcompass Healthcare

  • Psychiatric Hospital
  • Lawrenceburg, IN
  • NPI 1588732747
  Medicare reassignment Care Compare group NPD
• Norton - Kings Daughters Health Inc

  dba Norton King's Daughters' Health

  • Family Medicine Physician
  • Madison, IN
  • NPI 1114955093
  Medicare reassignment NPD
• Norton - Kings Daughters Health Inc

  dba Kings Daughters Health

  • Clinical Medical Laboratory
  • Madison, IN
  • NPI 1497024426
  NPD
• Tristate Pathology and Forensic Services LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lawrenceburg, IN
  • NPI 1649720244
  NPD

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1235893447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16601 STATE ROAD 250",
            "city": "RISING SUN",
            "state": "IN",
            "postal_code": "470408725",
            "telephone_number": "812-621-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 E STATE ROAD 62",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472507328",
            "telephone_number": "812-801-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28213316A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011714A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis L Smith, CRNA
• Tristyn Cheyne Smolarczyk
• SN Kentuckiana Rehab, LLC (KORT Kids -Madison)
• SN Kentuckiana Rehab, LLC (KORT Kids -Madison)
• SN Kentuckiana Rehab, LLC (KORT Physical Therapy)
• Gayle E. Spaulding, D.M.D.
• John R. Spaulding Jr., D.D.S.
• Spauldings Dental Office
• Patrick W Stack, M.D.
• Susan M Stack, M.D.

• Family Nurse Practitioner in Madison, IN
• Providers in Madison, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.