Mary L Sparkes, MD
Individual provider Active NPI Emergency Medicine Physician · Savannah, GA
NPI 1891737441 · NPPES record last updated Aug 7, 2023
Key facts
- NPI
- 1891737441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 038102 (GA)
- Practice address
- 5 Executive Cir
Savannah, GA 31406-3345 - Phone
- (912) 355-2400
- Fax
- (912) 355-5324
- NPI assigned
- Jun 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Medical College of Wisconsin, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- East Georgia Healthcare Center, Inc.
Practice addresses (Care Compare)
330 Mims Rd
Sylvania, GA 30467-1904
Phone (912) 451-5887
Hospital & facility affiliations
- Jenkins County Medical Center
- Piedmont Augusta Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040720001501 | GA | Practitioner - Emergency Medicine | 9335044650 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038102 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Georgia Healthcare Center, Inc. | Current |
Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Current |
Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Current | Accepting new patients | |
| Georgia Emergency Associates Immediate Care Center | Current | Accepting new patients | |
| Georgia Emergency Associates Immediate Care Center | Past | Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Past | Accepting new patients | |
| Carolina Emergency Associates | Emergency Medicine | Past | Accepting new patients |
| The Baxley and Appling County Hospital Authority | Past | Accepting new patients | |
| Advanced Pediatric Specialists LLC | Past | Accepting new patients |
Locations
1075 E Winthrope Ave
Millen, GA 30442
Phone (478) 237-2638
5621 Highway 21 S
Rincon, GA 31326
Phone (912) 295-5860
361 Commercial Dr
#F
Savannah, GA 31406
Phone (912) 355-2400
361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221
5 Executive Cir
Savannah, GA 31406
Phone (912) 355-2400
215 N Coleman St
Swainsboro, GA 30401
Phone (478) 237-2638
330 Mims Rd
Sylvania, GA 30467
Phone (912) 451-5887
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 038102 | GA | |
| Emergency Medicine Physician | 207P00000X | 038102 | GA | Yes |
| Emergency Medicine Physician | 207P00000X | 27316 | SC |
Addresses
Primary practice location
5 Executive Cir
Savannah, GA 31406-3345
Mailing address
5 Executive Cir
Savannah, GA 31406-3345
Phone (912) 355-2400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000591313K | Medicaid | GA | |
| 10058953 | Other | GA | AMERIGROUP |
| 000591313 | Medicaid | GA | |
| G38102 | Medicaid | SC | |
| 000591313B | Medicaid | GA | |
| 000591313M | Medicaid | GA | |
| 000591313C | Medicaid | GA | |
| 000591313F | Medicaid | GA | |
| F284498055 | Medicaid | SC | |
| 000591313D | Medicaid | GA | |
| 000591313L | Medicaid | SC |
Other providers in Savannah, GA
- Amanda Kelly Southwood
- Mary Nicely Sowers
- Maria Alejandra Spagnolo Leon
- Spanish Oaks Hospice Inc
- Rose Marie Spann
- James Lee Spawn
- Lynn Spear
- Douglas Alan Spears
- Adam Walter Specjal
- Frederic C Spector
All providers in Savannah, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.