Sparkle Care Family Health NP PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SPARKLE CARE FAMILY HEALTH NP PLLC

Practice address

25 Nicoll Ave
Central Islip, NY 11722-3136

Phone

(631) 605-4089

NPI assigned

Mar 23, 2023

Organization subpart

No

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

Authorized official

Name

Takeisha Judkins, NPNPI 1891066429

Title

Director

Phone

(631) 605-4089

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Takeisha Judkins, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Jamaica, NY
  • NPI 1891066429
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1831892462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 NICOLL AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117223136",
            "telephone_number": "631-605-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NICOLL AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117223136",
            "telephone_number": "631-605-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLE CARE FAMILY HEALTH NP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "JUDKINS",
        "authorized_official_first_name": "TAKEISHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-605-4089",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Taft Smith Jr., L.C.S.W.
• Marilyn C Solano-Foster, LCSW-R
• Southside Hospital
• Monique Souza
• Nicole B Souza, LMSW
• Rebecca Stegner
• Toni-Cara Stellitano, LCSW
• Rashanda Stephenson-Scott
• Jazmin Krystal Sturdivant
• Suffolk County Dept of Health Services

• Clinic/Center in Central Islip, NY
• Providers in Central Islip, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.