Individual provider Active NPI

Jessica Paige Sparks, MSN, APRN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1306302468
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
3013165 Issued in KY
Practice address
2828 1St Ave Ste 510
Huntington, WV 25702-1236
Phone
(304) 399-7548
Fax
(304) 399-7507
NPI assigned
Feb 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 3013165 KY Primary

Addresses

Primary practice location

2828 1St Ave Ste 510
Huntington, WV 25702-1236

Mailing address

PO Box 4190
Barboursville, WV 25504-4190
Phone (304) 908-9202

Other practice location 1

5262 W US Highway 60
Olive Hill, KY 41164-8058
Phone (606) 316-0718

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica.sparks@smmm.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20190618003530 WV Practitioner - Nurse Practitioner 7719211135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2828 1St Ave
Suite 510
Huntington, WV 25702-1236
Phone (304) 399-7484

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3013165KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Medical Management, LLC CurrentSince Jun 10, 2019 Accepting new patients
St. Mary'S Medical Management, LLC CurrentSince Jun 10, 2019 Accepting new patients

Locations

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

2828 1st Ave
Ste 510
Huntington, WV 25702
Phone (304) 399-7548

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1306302468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4190",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044190",
            "telephone_number": "304-908-9202",
            "fax_number": "304-399-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 1ST AVE STE 510",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-399-7548",
            "fax_number": "304-399-7507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5262 W US Highway 60",
            "address_purpose": "LOCATION",
            "city": "Olive Hill",
            "state": "KY",
            "postal_code": "411648058",
            "country_code": "US",
            "telephone_number": "606-316-0718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "JESSICA",
        "middle_name": "PAIGE",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3013165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.sparks@smmm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2828 1st Ave Ste 510",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257021236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.