Individual provider Active NPI

Susan K Sparling, MD

  • Family Medicine Physician
  • Medford, OR
National Provider Identifier
1679532501
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60291310 Issued in WA
Practice address
19 Myrtle St
Medford, OR 97504-7337
Phone
(541) 773-3863
Fax
(541) 776-2892
NPI assigned
Mar 20, 2006
Last updated
Oct 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60291310 WA Primary

Addresses

Primary practice location

19 Myrtle St
Medford, OR 97504-7337

Mailing address

19 Myrtle St
Medford, OR 97504-7337
Phone (541) 773-3863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, AK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070529000055 OR Practitioner - Family Practice 8729185707 Reassigns benefits to 1 organization
I20210526002796 AK Practitioner - Family Practice 8729185707 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60291310WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Klamath Tribal Health & Family Services CurrentSince Nov 26, 2023 Accepting new patients
Moses Lake Community Health Center CurrentSince Nov 7, 2012 Accepting new patients
Sunshine Community Health Center Inc CurrentSince May 17, 2021 Accepting new patients
Klamath Tribal Health & Family Services CurrentSince Nov 26, 2023 Accepting new patients
Sunshine Community Health Center Inc Current Accepting new patients
Sunshine Community Health Center, Inc CurrentSince May 17, 2021 Accepting new patients
Moses Lake Community Health Center PastSince Nov 7, 2012 Accepting new patients

Locations

3949 S 6th St
Klamath Falls, OR 97603
Phone (541) 882-1487

6000 New Way
Klamath Falls, OR 97601
Phone (541) 884-1841

605 S Coolidge St
#101
Moses Lake, WA 98837
Phone (509) 765-0674

Organizations & group practices 7

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1679532501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-773-3863",
            "fax_number": "541-776-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-773-3863",
            "fax_number": "541-776-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARLING",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60291310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.