Individual provider Active NPI

Clayton E Sparks, D.C.

  • Chiropractor
  • Jacksonville, NC
National Provider Identifier
1477517936
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2590 Issued in NC
Practice address
3227 Henderson Drive Ext.
Jacksonville, NC 28546
Phone
(910) 355-2225
Fax
(910) 938-2225
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2590 NC Primary

Addresses

Primary practice location

3227 Henderson Drive Ext.
Jacksonville, NC 28546

Mailing address

3227 Henderson Dr
Jacksonville, NC 28546-5251
Phone (910) 355-2225

Other identifiers 2

IdentifierTypeStateIssuer
890838MedicaidNC
890838VMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050215000329 NC Practitioner - Chiropractic 8224089271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sparks Chiropractic Services PAGroup PAC ID 4789635731, 2 clinicians

Practice addresses (Care Compare)

3220 Henderson Dr
Jacksonville, NC 28546-5250
Phone (910) 355-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2590NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sparks Chiropractic Services PA Chiropractor CurrentSince Jan 1, 2005 Accepting new patients
Sprague, PLLC Chiropractor Past Accepting new patients
Schilsky Chiropractic Center PA Chiropractor Past Accepting new patients

Locations

3227 Henderson Dr
Jacksonville, NC 28546
Phone (910) 355-2225

3220 Henderson Dr
Jacksonville, NC 28546
Phone (910) 238-4348

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1477517936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3227 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465251",
            "telephone_number": "910-355-2225",
            "fax_number": "910-938-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 HENDERSON DRIVE EXT.",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28546",
            "telephone_number": "910-355-2225",
            "fax_number": "910-938-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "CLAYTON",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890838",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890838V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.