NPIMap

Organization Active NPI

Sparks Chiropractic LLC

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1982247698
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SPARKS CHIROPRACTIC LLC
Practice address
11125 NE Sandy Blvd
Portland, OR 97220-2555
Phone
(503) 257-3377
Fax
(503) 257-3432
NPI assigned
Oct 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Authorized official

Name
Dr. Beau William Sparks, DC
Title
Chiropractic Physician
Phone
(503) 257-3377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

11125 NE Sandy Blvd
Portland, OR 97220-2555

Mailing address

11125 NE Sandy Blvd
Portland, OR 97220-2555
Phone (503) 257-3377

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1982247698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202555",
            "telephone_number": "503-257-3377",
            "fax_number": "503-257-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202555",
            "telephone_number": "503-257-3377",
            "fax_number": "503-257-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "503-257-3377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.