Active NPI
Melanie Y Sparks, PT, DPT
- Physical Therapist
- Mattoon, IL
National Provider Identifier
1336796028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070024580
- Practice address
- 200 Lerna Rd S
Mattoon, IL 61938-9300 - Phone
- (217) 238-5666
- Fax
- (217) 238-5692
- NPI assigned
- Aug 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070024580 | IL | Primary |
Addresses
Primary practice location
200 Lerna Rd S
Mattoon, IL 61938-9300
Mailing address
611 W Park St
Urbana, IL 61801-2529
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070024580 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566172800000",
"number": "1336796028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 LERNA RD S",
"city": "MATTOON",
"state": "IL",
"postal_code": "619389300",
"telephone_number": "217-238-5666",
"fax_number": "217-238-5692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "MELANIE",
"middle_name": "Y",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-19",
"last_updated": "2019-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070024580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattoon, IL
- Joseph P. So, M.D.
- Southern Illinois Healthcare Foundation, Inc
- Southern Illinois Healthcare Foundation, Inc
- Amber Sowers, APRN
- Angie Sowers, B.A.
- Rebecca Eugenia Sparks, ANP
- Paige A Sparling
- Edward Spring
- St Anthonys Memorial Hospital of the Hospital Sisters of the Third
- Shannon Lynn Stallworth, L.M.T,NCTMB
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.