Individual provider Active NPI

Justin David Sparhawk, OD

  • Corneal and Contact Management Optometrist
  • Nampa, ID
National Provider Identifier
1669552048
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
ODP-100122 Issued in ID
Practice address
2025 12TH Ave Rd
Nampa, ID 83686-6459
Phone
(208) 461-1000
Fax
(208) 461-0969
NPI assigned
Oct 17, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100122 ID
Corneal and Contact Management Optometrist 152WC0802X ODP-100122 ID Primary

Addresses

Primary practice location

2025 12TH Ave Rd
Nampa, ID 83686-6459

Mailing address

781 N Shadowridge Ave
Eagle, ID 83616-5674
Phone (208) 939-3294

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100122IDMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carter Vision Care, PLLC Optometrist Past Accepting new patients
Canyon Ofp, PLLC PastSince Aug 1, 2010 Accepting new patients
Vision Pro II Inc Optometrist PastSince Aug 1, 2012 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1669552048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 N SHADOWRIDGE AVE",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165674",
            "telephone_number": "208-939-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866459",
            "telephone_number": "208-461-1000",
            "fax_number": "208-461-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARHAWK",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100122",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "ID",
            "license": "ODP-100122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.