Randal P Sparks, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

52538 Issued in MN

Practice address

600 East Fairview Avenue
Olivia, MN 56277-1399

Phone

(320) 523-1460

NPI assigned

Aug 31, 2006

Last updated

Jun 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN, AL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: randal.sparks.1@14429.direct.athenahealth.com

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.

• Health Services Inc

  dba Montevallo Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Montevallo, AL
  • NPI 1891257390
  Medicare reassignment NPD
• Healthpartners RC

  dba Olivia Hospital & Clinic

  • Critical Access Hospital Clinic/Center
  • Olivia, MN
  • NPI 1649470782
  Medicare reassignment
• Healthpartners RC

  dba Olivia Hospital & Clinic

  • Critical Access Hospital
  • Olivia, MN
  • NPI 1629091871
  NPD
• Health Services Inc

  dba Hayneville Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hayneville, AL
  • NPI 1598788218
  NPD
• Health Services, Inc

  dba Montgomery Primary Care

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1528082336
  NPD
• Health Services, Inc.

  dba Living Well Specialty Clinic

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1184284986
  NPD
• Gill Family Medicine, P.C.

  • Family Medicine Physician
  • Decatur, AL
  • NPI 1144574872
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1831201144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E PARK AVE",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562771370",
            "telephone_number": "320-523-1460",
            "fax_number": "320-523-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST FAIRVIEW AVENUE",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562771399",
            "telephone_number": "320-523-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "RANDAL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO-437",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "52538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51028285",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529402090",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6309683290010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0110005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004119242",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renville County Human Services
• Renville Olivia Holdings LLC (Olivia Restorative Care Center)
• Ridgeview Clinics (Western Orthopaedics & Sports Medicine Consultants)
• Jennifer Elizabeth Robideau, DC
• Marykay Sinner
• St. Cloud Hospital (CentraCare Kidney Program - Olivia)
• Heather Jean Strobel, PHARM.D.
• Annmarie J Suess, RN PHN
• Sward-Kemp Drug Co of Olivia Inc (Page Snyder Drug)
• TC Audiology LLC (TC Audiology)

• Family Medicine Physician in Olivia, MN
• Providers in Olivia, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.