Individual provider Active NPI

Samantha Ashley Sparks

  • Certified Registered Nurse Anesthetist
  • Dayton, OH
National Provider Identifier
1972177848
Registry record updated May 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.0020296 Issued in OH
Practice address
1 Wyoming St
Dayton, OH 45409-2643
Phone
(937) 208-6173
Fax
(937) 208-3843
NPI assigned
May 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.0020296 OH Primary

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2643

Mailing address

PO Box 632317
Cincinnati, OH 45263-2317
Phone (717) 263-5562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210630002646 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648671412 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

3130 N Co Rd
25A
Troy, OH 45373
Phone (937) 440-4000

Hospital & facility affiliations

  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Anesthesia Partners LLC CurrentSince May 8, 2025 Accepting new patients
Anesthesiology Services Network LTD CurrentSince Jun 2, 2021 Accepting new patients
PHS Anesthesia Billing, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

450 N Hyatt St
Ste 308
Tipp City, OH 45371
Phone (614) 561-5233

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621123200000",
    "number": "1972177848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632317",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632317",
            "telephone_number": "717-263-5562",
            "fax_number": "717-263-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092643",
            "telephone_number": "937-208-6173",
            "fax_number": "937-208-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "SAMANTHA",
        "middle_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-16",
        "last_updated": "2021-05-16",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0020296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.