Active NPI
Sparta Corp
- Family Medicine Physician
- Russellville, AR
National Provider Identifier
1508233701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
National Provider Directory
National Provider DirectoryLocations
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.