Individual provider Active NPI

Jennifer Sparks, FNP-CNP

  • Family Nurse Practitioner
  • Woodward, OK
National Provider Identifier
1780041384
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
205506 Issued in OK
Practice address
1611 Main St Ste 102
Woodward, OK 73801-3064
Phone
(580) 254-8652
NPI assigned
Jan 27, 2016
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 205506 OK Primary
Registered Nurse 163W00000X R 0071514 OK

Addresses

Primary practice location

1611 Main St Ste 102
Woodward, OK 73801-3064

Mailing address

PO Box 1213
Laverne, OK 73848-1213
Phone (580) 254-5322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220118001152 OK Practitioner - Nurse Practitioner 1153713417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

718 Ave a
Beaver, OK 73932-3101
Phone (580) 625-3477

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 0071514OKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver County Memorial Hospital CurrentSince Dec 15, 2021 Accepting new patients
Beaver County Memorial Hospital CurrentSince Dec 15, 2021 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Oct 13, 2025 Accepting new patients
Integris Health Woodward Hospital Inc Past Accepting new patients
Beaver County Memorial Hospital Past Accepting new patients

Locations

718 Avenue A
Beaver, OK 73932
Phone (580) 625-3477

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

Interoperability endpoints

  • Direct secure messaging: jsparks546397@direct.integrisok.com
  • Direct secure messaging: jsparks97541@direct-ehr-ssmhc.com

Organizations & group practices 5

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 3

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": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1780041384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1213",
            "city": "LAVERNE",
            "state": "OK",
            "postal_code": "738481213",
            "telephone_number": "580-254-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 MAIN ST STE 102",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013064",
            "telephone_number": "580-254-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "JENNIFER",
        "credential": "FNP-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "205506",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R 0071514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodward, OK

Sources for this page

Verify at the official NPI Registry.