Sparks Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

SPARKS DIALYSIS LLC

Practice address

3140 Long Beach Blvd
Long Beach, CA 90807-5061

Phone

(562) 988-8866

NPI assigned

May 14, 2021

Organization subpart

No

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other names 1

• Quest Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George G Hon, MD

  • Nephrology Physician
  • Paramount, CA
  • NPI 1699772350
  NPD (past)

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1316511397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 LONG BEACH BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908075061",
            "telephone_number": "562-988-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quest Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanika Nicole Soward, NURSE PRACTITIONER
• Christina Sowers
• Lauren Spady
• Jarrod Matthew Spanjer, ATC
• Jenn Spanjer, ATC, CSCS
• Deanna Sparks
• Giovanna Spata
• Kimberly Renee Spears
• Special Service for Groups
• Special Service for Groups

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.