Active NPI
Gracie Sparks
- Behavior Analyst
- Paducah, KY
National Provider Identifier
1437938313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB559713
- Practice address
- 619 N 30TH St
Paducah, KY 42001-4047 - Phone
- (270) 444-7898
- NPI assigned
- Sep 28, 2023
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BACB559713 | KY | Primary |
Addresses
Primary practice location
619 N 30TH St
Paducah, KY 42001-4047
Mailing address
1102 Elm St # Sr
Benton, KY 42025-1554
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 |
|---|---|---|---|
| BACB559713 | KY | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1437938313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1102 ELM ST # SR",
"city": "BENTON",
"state": "KY",
"postal_code": "420251554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 N 30TH ST",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420014047",
"telephone_number": "270-444-7898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "GRACIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-28",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "KY",
"license": "BACB559713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.