Organization Active NPI

Sparta Corp

  • Family Medicine Physician
  • Russellville, AR
National Provider Identifier
1508233701
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SPARTA CORP
Doing business as
Streamline Clinic
Practice address
700 E Parkway Dr
Russellville, AR 72801-4202
Phone
(479) 567-5770
Fax
(479) 567-5104
NPI assigned
Aug 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Authorized official

Name
Jeremy Saul, MD
Title
Owner
Phone
(479) 280-3771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

700 E Parkway Dr
Russellville, AR 72801-4202

Mailing address

PO Box 9178
Russellville, AR 72811-9178
Phone (800) 824-4094

Other names 1

  • Streamline Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

115 E Harrell Dr
Russellville, AR 72802

221 E 4th St
Russellville, AR 72801
Phone (479) 567-5770

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1508233701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "800-824-4094",
            "fax_number": "479-968-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E PARKWAY DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728014202",
            "telephone_number": "479-567-5770",
            "fax_number": "479-567-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "SAUL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-280-3771",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Streamline Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.