Organization Active NPI

Robert W. Sparks, D.O, P.C.

  • Family Medicine Physician
  • Kirksville, MO
National Provider Identifier
1992984967
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9D41 Issued in MO
Legal business name
ROBERT W. SPARKS, D.O, P.C.
Practice address
2200 S Halliburton St
Kirksville, MO 63501-4651
Phone
(660) 627-1560
Fax
(660) 665-0533
NPI assigned
Oct 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Authorized official

Name
Dr. Robert W Sparks, D.O.
Title
Physician/Owner
Phone
(660) 627-1560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X R9D41 MO Primary

Addresses

Primary practice location

2200 S Halliburton St
Kirksville, MO 63501-4651

Mailing address

2200 S Halliburton St
Kirksville, MO 63501-4651
Phone (660) 627-1560

Other identifiers 1

IdentifierTypeStateIssuer
505674903MedicaidMO

National Provider Directory

National Provider Directory

Locations

2200 S Halliburton St
Kirksville, MO 63501
Phone (660) 627-1560

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1992984967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 S HALLIBURTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014651",
            "telephone_number": "660-627-1560",
            "fax_number": "660-665-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 S HALLIBURTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014651",
            "telephone_number": "660-627-1560",
            "fax_number": "660-665-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W. SPARKS, D.O, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "660-627-1560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9D41",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505674903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.