Active NPI
Theresa B. Sparkman, M.D.
- Psychiatry Physician
- Randolph AFB, TX
National Provider Identifier
1851373419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 18703
- Practice address
- 221 3Rd St W
Randolph AFB, TX 78150-4800 - Phone
- (509) 247-5217
- NPI assigned
- Nov 18, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35.075705 | OH | |
| Psychiatry Physician | 2084P0800X | 18703 | NE | Primary |
Addresses
Primary practice location
221 3Rd St W
Randolph AFB, TX 78150-4800
Mailing address
221 3Rd St W
Randolph AFB, TX 78150-4800
Phone (509) 247-5217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.075705 | OH | MD | Pediatrics Physician |
| 18703 | NE | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244764800000",
"number": "1851373419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 3RD ST W",
"city": "RANDOLPH AFB",
"state": "TX",
"postal_code": "781504800",
"telephone_number": "509-247-5217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 3RD ST W",
"city": "RANDOLPH AFB",
"state": "TX",
"postal_code": "781504800",
"telephone_number": "509-247-5217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKMAN",
"first_name": "THERESA",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-18",
"last_updated": "2009-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35.075705",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NE",
"license": "18703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randolph AFB, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.