Active NPI
Caitlin Sparks
- Physician Assistant
- Montgomery, AL
National Provider Identifier
1942955257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4760 Woodmere Blvd
Montgomery, AL 36106-3065 - Phone
- (334) 288-0814
- NPI assigned
- Feb 15, 2022
- Last updated
- Apr 15, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary |
Addresses
Primary practice location
4760 Woodmere Blvd
Montgomery, AL 36106-3065
Mailing address
105 Lismore Dr
Lagrange, GA 30240-9580
Phone (334) 354-4047
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone (334) 288-0814
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1976 | AL | MD | Clinical Psychologist |
Organizations & group practices 3
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.
-
- Nephrology Physician
- Montgomery, AL
- NPI 1881659423
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Baptist Medical Center South
- General Acute Care Hospital
- Montgomery, AL
- NPI 1700977105
-
dba Elmore Community Hospital
- General Acute Care Hospital
- Wetumpka, AL
- NPI 1588795942
-
dba Prattville Baptist Hospital
- General Acute Care Hospital
- Prattville, AL
- NPI 1942391230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649980800000",
"number": "1942955257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 LISMORE DR",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302409580",
"telephone_number": "334-354-4047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4760 WOODMERE BLVD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361063065",
"telephone_number": "334-288-0814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "CAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-15",
"last_updated": "2022-04-15",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
- Southwest Alabama Maternity Care
- Sovereignty Design Services LLC (Phoenix Rising Therapy)
- Madison Spain
- Stephanie T Spann, MSW
- Elizabeth Sparks Brewer, M.ED., ALC, NCC
- Ashley Spear, RN
- Special Care Dental of Al LLC
- Specialized Alternatives for Families and Youth of America, Inc. (SAFY of Alabama)
- Spectrum Specialists Inc
- Danielle Franklin Speight, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.