Lisa Lam Sparks, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014189 Issued in CA

Practice address

16465 Sierra Lakes Pkwy
Fontana, CA 92336-1242

Phone

(909) 434-1150

NPI assigned

Mar 19, 2020

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Fontana, CA
  • NPI 1023306784

  CA

  Medicare reassignment Care Compare group NPD
• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Pomona, CA
  • NPI 1801233036
  NPD

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

• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Urgent Care Group Inc 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18095/brand/2/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 24, 2023.

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1780210989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-434-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-434-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "LISA",
        "middle_name": "LAM",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern California Permanente Medical Group
• Southern California Permanente Medical Group
• Southern California Permanente Medical Group
• Southern California Picc Providers, Inc.
• Southridge Dental Group
• Robert Speaks
• Rebecca Spence Dobias
• Clairessa M Spencer, LCSW
• Kim L. Spencer, MD
• Marcia Spencer, LMFT

• All providers in Fontana, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.