Spark Therapy Group LLC

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

4054 Issued in SC

Legal business name

SPARK THERAPY GROUP LLC

Practice address

9 Drexel Ave
Greenville, SC 29615-1407

Phone

(864) 270-4799

NPI assigned

Feb 1, 2017

Organization subpart

No

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

Authorized official

Name

Heather Nelson

Title

Physical Therapist

Phone

(864) 270-4799

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1871031641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 E NORTH ST STE 1108-176",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296151442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 DREXEL AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296151407",
            "telephone_number": "864-270-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "864-270-4799"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SC",
            "license": "4054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregorio O'Neill Spagnolo, PA-C
• Shelley M. Spang, CRNA
• Belle Spangle
• Stephanie Ann Spanioli, NP
• Spark Dental SC LLC
• Rida Sparks-Freemont, APRN, FNP-BC
• Clarissa Sparks, RBT
• Kaelyn Brett Sparks, APRN
• Macy Sparks, OD
• Tyler G Sparks, MD

• Pediatric Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Pediatric Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.