Logan Sparks, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010419 Issued in MI

Practice address

3815 Pelham St Ste 13
Dearborn, MI 48124-3852

Phone

(313) 722-4683

Fax

(313) 241-9342

NPI assigned

Jan 19, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Michigan Advanced Psychiatry, P.C.Group PAC ID 2567877574, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Michigan Advanced Psychiatry, P.C.

  • Psychiatry Physician
  • Ann Arbor, MI
  • NPI 1629686837
  Medicare reassignment Care Compare group
• Taylor Urgent Care PC

  • Urgent Care Clinic/Center
  • Taylor, MI
  • NPI 1013321033
  Medicare reassignment NPD
• Best Urgent Care PC

  • Urgent Care Clinic/Center
  • Redford, MI
  • NPI 1952791105
  Medicare reassignment
• Canton Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Canton, MI
  • NPI 1649712480
  Medicare reassignment
• Chesterfield Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Chesterfield, MI
  • NPI 1629547195
  Medicare reassignment
• Clinton Urgent Care Walk-in Clinic

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1831610070
  Medicare reassignment
• Commerce Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Commerce TWP, MI
  • NPI 1952823825
  Medicare reassignment
• Core Psych PLLC

  • Psychiatry Physician
  • Dearborn, MI
  • NPI 1871069039
  Medicare reassignment
• Doctors Urgent Care Southfield

  • Urgent Care Clinic/Center
  • Southfield, MI
  • NPI 1326660929
  Medicare reassignment
• Rochester Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Rochester Hills, MI
  • NPI 1225554694
  Medicare reassignment
• Shelby Urgent Care Walk-in Clinic

  • Family Medicine Physician
  • Shelby TWP, MI
  • NPI 1285155119
  Medicare reassignment
• Sterling Heights Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Sterling Heights, MI
  • NPI 1912413949
  Medicare reassignment

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1306436845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 PELHAM ST STE 13",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243852",
            "telephone_number": "313-722-4683",
            "fax_number": "313-241-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 PELHAM ST STE 13",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243852",
            "telephone_number": "313-722-4683",
            "fax_number": "313-241-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "LOGAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-19",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Michigan Interventional Pain Specialists
• Southeast Michigan Surgical Hospital, LLC
• Southfield Rehabilitation Company
• Malalda Darlene Sow
• Leo D Sowle, DC
• Margarita Sparks, LLMSW
• Talore Lenea Sparks
• Taresa Mae Sparks
• Spartan Surgical Associates PLC
• Shereta Spearman

• Physician Assistant in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.