Active NPI
Kenneth E Sparr, MD
- Urology Physician
- Stevens Point, WI
National Provider Identifier
1366536104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 35645
- Practice address
- 824 Illinois Ave
Stevens Point, WI 54481-3112 - Phone
- (715) 342-7500
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 35645 | WI | Primary |
Addresses
Primary practice location
824 Illinois Ave
Stevens Point, WI 54481-3112
Mailing address
824 Illinois Ave
Stevens Point, WI 54481-3112
Phone (715) 342-7500
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13893 | Other | DEAN HEALTH PLAN | |
| 2013057 | Other | PHYSICIANS PLUS | |
| 35645-20 | Other | WI | WI STATE LIC |
| 390808509 | Other | CIGNA | |
| 390808509DN | Other | UNITY | |
| 16800226 | Other | MEDICARE PART B | |
| 34110500 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330646400000",
"number": "1366536104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 ILLINOIS AVE",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544813112",
"telephone_number": "715-342-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 ILLINOIS AVE",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544813112",
"telephone_number": "715-342-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARR",
"first_name": "KENNETH",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2012-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WI",
"license": "35645",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN",
"identifier": "13893",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS PLUS",
"identifier": "2013057",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI STATE LIC",
"identifier": "35645-20",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "390808509",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITY",
"identifier": "390808509DN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "16800226",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34110500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stevens Point, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.