SH Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD.205277 Issued in LA

Legal business name

SH MEDICAL GROUP

Practice address

1025 Highway 80
Haughton, LA 71037-7425

Phone

(318) 949-0539

Fax

(318) 949-0759

NPI assigned

Oct 20, 2016

Organization subpart

No

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

Authorized official

Name

Stacey Des Marais Sparks, M.D.

Title

Co Owner

Phone

(318) 949-0539

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Acorn to Oak Pediatrics Doing business as

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1407307887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 HIGHWAY 80",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710377425",
            "telephone_number": "318-949-0539",
            "fax_number": "318-949-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 HIGHWAY 80",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710377425",
            "telephone_number": "318-949-0539",
            "fax_number": "318-949-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "DES MARAIS",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "318-949-0539",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "MD.205277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "MD.205277",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515728",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acorn to Oak Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meghan Jean Sanders, DC
• Richard T Sanders, D.C.
• Lawrence William Scott Jr.
• Rosilind Wilson Scott, SLP
• Ian Elliott Seng, PHARM D
• Nutisha Lacole Simmons, CST
• Sharon Renee Simms, RT
• Smart Health Care
• Gail Smith
• Jennifer M Smith, RPH

• Specialist in Haughton, LA
• Providers in Haughton, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.