Kaelyn Brett Sparks, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26224 Issued in SC

Practice address

14 Edgewood Dr
Greenville, SC 29605-4246

Phone

(864) 250-7944

Fax

(864) 250-9582

NPI assigned

Oct 27, 2022

Last updated

Sep 13, 2024By 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 names 1

• Kaelyn Brett Sherley Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greenwood Genetic Center LabGroup PAC ID 9830097039, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksparks473664@direct.musc.edu

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.

• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Greenwood, SC
  • NPI 1649261462
  Medicare reassignment Care Compare group NPD
• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Greenville, SC
  • NPI 1134566953
  Medicare reassignment NPD
• Greenwood Genetic Center Lab

  • Clinical Medical Laboratory
  • Greenwood, SC
  • NPI 1669463014
  NPD
• Shriners Hospitals for Children

  dba Shriners Children's

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1275271462
  NPD
• Shriners Hospitals for Children

  dba Shriners Children's Hawaii

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1447977681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 GREGOR MENDEL CIR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462315",
            "telephone_number": "864-941-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 EDGEWOOD DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054246",
            "telephone_number": "864-250-7944",
            "fax_number": "864-250-9582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Gregor Mendel Cir",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296462315",
            "country_code": "US",
            "telephone_number": "864-941-8100 x3986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "KAELYN",
        "middle_name": "BRETT",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAELYN",
            "last_name": "SHERLEY",
            "middle_name": "BRETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Spark Dental SC LLC (Oak Tree Pediatric Dentistry)
• Spark Orthodontics SC LLC (Oak Tree Orthodontics)
• Spark Therapy Group LLC
• Rida Sparks-Freemont, APRN, FNP-BC
• Clarissa Sparks, RBT
• Macy Sparks, OD
• Tyler G Sparks, MD
• Kelly Pyle Sparrow
• Spartanburg Medical Center (Medical Group of the Carolinas - Urgent Care - Pelham)
• Spartanburg Medical Center (Medical Group of the Carolinas - Milestone Family Medicine)

• Family Nurse Practitioner in Greenville, SC
• Providers in Greenville, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.