Brian Keith Sparks, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD190671 Issued in OR

Practice address

9155 SW Barnes Rd Ste 333
Portland, OR 97225-6630

Phone

(503) 216-5102

Fax

(971) 282-0091

NPI assigned

Apr 6, 2012

Sex

Male

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

Enrolled in CA, OR2 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

Specialty

Psychiatry

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bsparks2768341@oc.providencedirect.org

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.

• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Medicare reassignment NPD
• County of Humboldt

  • State or Local Public Health Clinic/Center
  • Eureka, CA
  • NPI 1871676213
  Medicare reassignment NPD
• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paso Robles, CA
  • NPI 1134287634
  Medicare reassignment NPD
• Traditions Psychiatry Group, P.C

  • Psychiatry Physician
  • Santa Rosa, CA
  • NPI 1083802979
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Portland, OR
  • NPI 1477827509
  NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745
  NPD
• Providence Health & Services Oregon

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• County of Humboldt

  • Community/Behavioral Health Agency
  • Eureka, CA
  • NPI 1033300306
  NPD
• County of Humboldt

  • Clinical Medical Laboratory
  • Eureka, CA
  • NPI 1689751687
  NPD
• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Luis Obispo, CA
  • NPI 1073501870
  NPD
• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arroyo Grande, CA
  • NPI 1932563053
  NPD

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1780940403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 333",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256630",
            "telephone_number": "503-216-5102",
            "fax_number": "971-282-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD190671",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A142587",
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "CA",
            "license": "A142587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spark Relational Counseling, LLC
• John Philip Allen Sparkenbach
• Sparking Hope LLC
• Young Sparkman
• Sparks Chiropractic LLC
• Emily Sparks, CADC-R
• Hillary Jo Sparks
• Jane Obermiller Sparks, PTA
• Kenneth Errol Sparks Jr., FNP-BC PMHNP-BC
• Julie Angela Sparlin, M.D.

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.