Individual provider Active NPI

David Michael Sparks, O.D.

  • Optometrist
  • Fairfield, OH
National Provider Identifier
1396078994
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6160 Issued in OH
Practice address
3174 Mack Rd
Ste 3
Fairfield, OH 45014-5369
Phone
(513) 874-2000
Fax
(513) 672-9222
NPI assigned
Sep 14, 2009
Last updated
Jun 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001888 VA
Optometrist 152W00000X 6160 OH Primary

Addresses

Primary practice location

3174 Mack Rd
Ste 3
Fairfield, OH 45014-5369

Mailing address

4860 Somerville Rd
Oxford, OH 45056
Phone (614) 499-0450

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

State licenses

LicenseStateTypeSpecialty
6160OHMDOptometrist
0618001888VAMDOptometrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1396078994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 SOMERVILLE RD",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "45056",
            "telephone_number": "614-499-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3174 MACK RD",
            "address_2": "STE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145369",
            "telephone_number": "513-874-2000",
            "fax_number": "513-672-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-14",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001888",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.