Courtnie Brooke Sparks, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305205742 Issued in VA

Practice address

2405 Atherholt Rd
Lynchburg, VA 24501-2184

Phone

(434) 485-8500

Fax

(434) 485-8599

NPI assigned

Nov 28, 2008

Last updated

Sep 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Courtnie Brooke Rutherford Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1227830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1447405790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "COURTNIE",
        "middle_name": "BROOKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-28",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447405790",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csparks6167@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Dr. Sparks direct address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "secure messaging",
            "address_1": "2405 Atherholt Rd",
            "city": "Lynchburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245012184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COURTNIE",
            "last_name": "RUTHERFORD",
            "middle_name": "BROOKE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.