Jennifer Sparks, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3634 Issued in MS

Practice address

4360 Hwy 39 N
Meridian, MS 39301

Phone

(601) 490-4494

Fax

(866) 404-9501

NPI assigned

Nov 28, 2022

Last updated

Nov 28, 2022By the provider in NPPES

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lighthouse Therapy LLC

  • Physical Therapist
  • Ocean Springs, MS
  • NPI 1801367883
  NPD

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1649980954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5703 GULF TECH DR",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395648238",
            "telephone_number": "228-875-5447",
            "fax_number": "866-404-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 HWY 39 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39301",
            "telephone_number": "601-490-4494",
            "fax_number": "866-404-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Family Markets LLC (Southern Family Market)
• Southern Home Care Agency LLC
• Southern Home Private Care LLC
• Southern Pain Associates, PLLC
• Southerncare, Inc. (SouthernCare Meridian)
• Specialized Medicine and Oxygen Care, PLLC
• Joan Crawford Speed, APMHNP-BC
• Betty Spells
• Fred Douglas Spencer Jr.
• Casey Springer

• Physical Therapist in Meridian, MS
• Providers in Meridian, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.