Kristin M Sparks, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302035970 Issued in MI

Practice address

3850 N Long Lake Rd
Traverse City, MI 49684-9601

Phone

(231) 947-2880

Fax

(231) 947-2901

NPI assigned

Dec 1, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1487809778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 N LONG LAKE RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849601",
            "telephone_number": "231-947-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 N LONG LAKE RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849601",
            "telephone_number": "231-947-2880",
            "fax_number": "231-947-2901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2772 Garfield Rd N",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496865004",
            "country_code": "US",
            "telephone_number": "231-922-9933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302035970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.