Kylee Rae Sparks, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006053 Issued in OH

Practice address

8259 Holmard PL
Indianapolis, IN 46259-7719

Phone

(317) 771-9492

NPI assigned

Jan 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1730546763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 HOLMARD PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462597719",
            "telephone_number": "317-771-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8259 HOLMARD PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462597719",
            "telephone_number": "317-771-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "KYLEE",
        "middle_name": "RAE",
        "name_prefix": "Miss",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Grace Sparks, OTR
• Jenna Renee Sparks, LAT, ATC
• John Calvin Sparks
• Kathleen Malone Sparks, ATC, LAT
• Kimberly Ann Sparks, MS CCC SLP
• Natalie C Sparks, M.A., B.C.B.A
• Rita Jane Sparks, LCSW
• Tiffany R Sparks
• Victoria Sparks, RD
• Sparrow Counseling Group, LLC

• Athletic Trainer in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.