Individual provider Active NPI

Sparkle Patrice Berry, BSW, CHW

  • Community Health Worker
  • Detroit, MI
National Provider Identifier
1629911490
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
3772404-019 Issued in MI
Practice address
4401 Conner St
Detroit, MI 48215-2201
Phone
(313) 571-2800
NPI assigned
Apr 14, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X 3772404-019 MI Primary

Addresses

Primary practice location

4401 Conner St
Detroit, MI 48215-2201

Mailing address

4088 Lemay St
Detroit, MI 48214-1646
Phone (313) 407-0214

Other practice location 1

4088 LeMay St
Detroit, MI 48214-1646
Phone (313) 407-0214

Other identifiers 1

IdentifierTypeStateIssuer
3772404-019MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3772404-019MIMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1629911490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4088 LEMAY ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482141646",
            "telephone_number": "313-407-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CONNER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152201",
            "telephone_number": "313-571-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4088 LeMay St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482141646",
            "country_code": "US",
            "telephone_number": "313-407-0214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "SPARKLE",
        "middle_name": "PATRICE",
        "credential": "BSW, CHW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "3772404-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3772404-019",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.