Jane Sparks, APRN
Individual provider Active NPI Family Nurse Practitioner · Monticello, UT
NPI 1285043885 · NPPES record last updated Aug 7, 2014
Key facts
- NPI
- 1285043885
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 67918724405 (UT)
- Practice address
- 380 West 100 North
Suite a
Monticello, UT 84535-1054 - Phone
- (435) 587-5054
- Fax
- (435) 587-3495
- NPI assigned
- Aug 7, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Juan County Hospital
Practice addresses (Care Compare)
380 W 100
Monticello, UT 84535-0308
Phone (435) 587-2116
380 W 100
Suite a
Monticello, UT 84535-7879
Phone (435) 587-5054
5555 Old Airport Rd
Spanish Valley, UT 84532-5105
Phone (435) 587-1234
PO Box
Suite 1054
Monticello, UT 84535
Hospital & facility affiliations
- San Juan Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161130002094 | UT | Practitioner - Nurse Practitioner | 1254636939 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67918724405 | UT | MD | Family Nurse Practitioner |
| 67918728900 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan County Hospital | Family Medicine | Current |
Accepting new patients |
| San Juan County Hospital | Current | Accepting new patients | |
| San Juan County Hospital | Family Medicine | Current |
Accepting new patients |
| San Juan County Hospital | Family Medicine | Past | Accepting new patients |
| San Juan County Hospital | Past | Accepting new patients |
Locations
735 S 200 W
Ste 3
Blanding, UT 84511
Phone (435) 678-2254
5555 Old Airport Rd
Moab, UT 84532
Phone (435) 419-9210
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 67918724405 | UT | Yes |
| Family Nurse Practitioner | 363LF0000X | 67918728900 | UT |
Addresses
Primary practice location
380 West 100 North
Suite a
Monticello, UT 84535-1054
Mailing address
380 West 100 North
Suite a
Monticello, UT 84535-1054
Phone (435) 587-5054
Other providers in Monticello, UT
- San Juan Dental
- San Juan Pharmacy Monticello Inc.
- San Juan Public Health
- Stetler Ladd Shumway
- Julee Dawn Slade
- Andrew Stevens
- Taylor G Wright, PC
- Utah Navajo Health System, Incorporated
- Utah Valley Radiology Assoc
- Jeanne Wigant
All providers in Monticello, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.