NPIMap

Organization Active NPI

Sparkman Nutrition, LLC

  • Registered Dietitian
  • Austin, TX
National Provider Identifier
1619332384
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT00782 Issued in TX
Legal business name
SPARKMAN NUTRITION, LLC
Practice address
4131 Spicewood Springs Rd
Suite L4
Austin, TX 78759-8661
Phone
(512) 257-0898
Fax
(512) 342-1043
NPI assigned
Dec 23, 2015
Last updated
Dec 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Alexa Fay Sparkman, MA, RDN,LDNPI 1801935051
Title
President
Phone
(512) 257-0898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT00782 TX Primary

Addresses

Primary practice location

4131 Spicewood Springs Rd
Suite L4
Austin, TX 78759-8661

Mailing address

4131 Spicewood Springs Rd
Suite L4
Austin, TX 78759-8661
Phone (512) 257-0898

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240712001576 TX Part B Supplier - Clinic/Group Practice 3375088420 Receives reassigned benefits from 7 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

4131 Spicewood Springs Rd
Ste L4
Austin, TX 78759
Phone (512) 454-0265

7701 N Lamar Blvd
Ste 402
Austin, TX 78752
Phone (512) 257-0898

17774 Cypress Rosehill Rd
Cypress, TX 77429
Phone (281) 205-7997

17774 Cypress Rosehill Rd
Ste 320
Cypress, TX 77429
Phone (281) 798-6775

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1619332384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD",
            "address_2": "SUITE L4",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598661",
            "telephone_number": "512-257-0898",
            "fax_number": "512-342-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD",
            "address_2": "SUITE L4",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598661",
            "telephone_number": "512-257-0898",
            "fax_number": "512-342-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKMAN NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "SPARKMAN",
        "authorized_official_first_name": "ALEXA",
        "authorized_official_middle_name": "FAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-257-0898",
        "authorized_official_credential": "MA, RDN,LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT00782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.