Individual provider Active NPI

Stephen Sparks, CRNP

  • Gerontology Nurse Practitioner
  • Cochranville, PA
National Provider Identifier
1700392966
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
8271370 Issued in ID
Practice address
10 Homestead LN
Cochranville, PA 19330-9642
Phone
(610) 406-2039
NPI assigned
Dec 22, 2017
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP018367 PA
Gerontology Nurse Practitioner 363LG0600X 8271370 ID Primary

Addresses

Primary practice location

10 Homestead LN
Cochranville, PA 19330-9642

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 302-9342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180410001930 PA Practitioner - Nurse Practitioner 4789947441 Reassigns benefits to 1 organization
I20251009003223 ID Practitioner - Nurse Practitioner 4789947441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

999 N Curtis Rd
Suite 415
Boise, ID 83706-1334
Phone (208) 302-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018367PAMDAcute Care Nurse Practitioner
8271370IDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Apr 1, 2018 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 15, 2025 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 15, 2025 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Apr 1, 2018 Accepting new patients
Saint Alphonsus Specialty Services Inc Past Accepting new patients
Prospect Health Access Network, Inc. Past Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

999 N Curtis Rd
Ste 415
Boise, ID 83706
Phone (208) 302-2600

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

4400 E Flamingo Ave
Ste 200
Nampa, ID 83687
Phone (208) 302-2100

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1700392966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-302-9342",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOMESTEAD LN",
            "city": "COCHRANVILLE",
            "state": "PA",
            "postal_code": "193309642",
            "telephone_number": "610-406-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "STEPHEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-22",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP018367",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ID",
            "license": "8271370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cochranville, PA

Sources for this page

Verify at the official NPI Registry.