Jennifer Dawn Sparks, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2975T Issued in OR

Practice address

629 Main St
Klamath Falls, OR 97601-6007

Phone

(541) 884-8322

Fax

(541) 884-7121

NPI assigned

Mar 24, 2006

Last updated

Jul 17, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OR, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pacific University - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Klamath Ophthalmology PCGroup PAC ID 4284620006, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Klamath Ophthalmology PC

  dba Klamath Eye Center

  • Ophthalmology Physician
  • Klamath Falls, OR
  • NPI 1730148271
  Medicare reassignment Care Compare group
• Klamath Ophthalmology PC

  dba Downtown Optical

  • Optometrist
  • Klamath Falls, OR
  • NPI 1902041676
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1285694000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 BIEHN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011181",
            "telephone_number": "541-884-8322",
            "fax_number": "541-884-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 MAIN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016007",
            "telephone_number": "541-884-8322",
            "fax_number": "541-884-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2975T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00208178",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022812",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "XSD000850",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "004571011",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "XSD000860",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Cascade Behavioral Health LLC
• Southern Oregon Chiropractic - Klamath Falls
• Southern Oregon Emergency Care LLC
• David John Sowers
• Shaun C Spalding, MD
• Lisa Marie Sparks, BRS CASE MANAGER
• Spectrum Orthotics and Prosthetics, Inc
• Wendy Jean Spencer, DMD
• Jonathan Michael Spicher, M.D.
• Amanda Spillane

• Optometrist in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.