Sparkle Green, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1181972 Issued in FL

Practice address

173 NW Albritton LN
Lake City, FL 32055-4451

Phone

(386) 755-4020

Fax

(386) 752-9143

NPI assigned

Jul 3, 2006

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 2

Other names 1

• Goldie Sparkle Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1487683074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 S MAIN ST",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326933239",
            "telephone_number": "352-463-2374",
            "fax_number": "352-463-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 NW ALBRITTON LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554451",
            "telephone_number": "386-755-4020",
            "fax_number": "386-752-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SPARKLE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "1181972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033364600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "1181972",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GOLDIE",
            "last_name": "GREEN",
            "middle_name": "SPARKLE",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Greater Gainesville Anesthesia Associates, LLC
• Daniel Joseph Green, RRT
• Jessica Lynn Green, LMT
• Sabrina Green
• Shanna Green, APRN
• Todd Green, PTA
• Virgiree Green
• Meagan Greenwood
• Gregory N Borganelli DMD PA
• Debra K Griffin, AU.D.

• Nurse Practitioner in Lake City, FL
• Providers in Lake City, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.