NPIMap

Organization Active NPI

Sparks Medical Foundatin

Doing business as Waldron Place Internal Medicine

  • Durable Medical Equipment & Medical Supplies
  • Fort Smith, AR
National Provider Identifier
1790880797
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SPARKS MEDICAL FOUNDATIN
Doing business as
Waldron Place Internal Medicine
Practice address
1501 S Waldron Rd
Ste 100
Fort Smith, AR 72903-2574
Phone
(479) 709-7310
Fax
(479) 709-7315
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rebecca Cox
Title
Cbo Support Manager
Phone
(479) 709-7057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X AR Primary

Addresses

Primary practice location

1501 S Waldron Rd
Ste 100
Fort Smith, AR 72903-2574

Mailing address

PO Box 2420
Fort Smith, AR 72902-2420
Phone (479) 709-7399

Other identifiers 1

IdentifierTypeStateIssuer
4454530012OtherARM-CARE DME

Other names 1

  • Waldron Place Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sparks Medical Foundation36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790880797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2420",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729022420",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD",
            "address_2": "STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-709-7310",
            "fax_number": "479-709-7315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS MEDICAL FOUNDATIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CBO SUPPORT MANAGER",
        "authorized_official_telephone_number": "479-709-7057"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE DME",
            "identifier": "4454530012",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waldron Place Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.