SHELLY RENAE SPARKS (NPI# 1962420109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962420109 |
| Entity Type | Individual |
| Full Name | SHELLY RENAE SPARKS |
| Credential | NP |
| Practice Address |
1210 Medical Arts Blvd Ste 117 Anderson IN 46011-3461 |
| Mailing Address |
8840 Commerce Park Pl Ste E Indianapolis IN 46268-3129 |
| Practice Telephone | 7652981792 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
71001150A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200357660 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 141 W 22nd St Ste 212, Anderson, IN 460164389 | 7656484138 | |
| 8890 E 116th St Ste 305, Fishers, IN 460382856 | 3176216696 | 3176216697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881015998 | Shelly Sparks | Social Worker | 1555 Industrial Dr, Owosso, MI 48867-9775 | 2013-12-17 |
| Street Address |
1210 MEDICAL ARTS BLVD STE 117 |
| City | ANDERSON |
| State | IN |
| Zip Code | 46011-3461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225509615 | Meghan Price | Nurse Practitioner | 1210 Medical Arts Blvd Ste 117, Anderson, IN 46011-3461 | 2018-12-10 |
| 1548512502 | Lesia Diana Mcbride | Nurse Practitioner | 1210 Medical Arts Blvd Ste 117, Anderson, IN 46011-3461 | 2012-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124662226 | Full Circle Family Solutions, LLC | Counselor | 909 Northwood Drive, Anderson, IN 46011 | 2019-10-31 |
| 1497186563 | Andrea C Rich | Social Worker | 1317 Winding Way, Anderson, IN 46011 | 2013-11-27 |
| 1093080848 | Franklin Keith Beeler | Family Medicine | 930 Summerlin Court, Anderson, IN 46011 | 2012-03-13 |
| 1063609642 | Christopher Place At Keystone Woods Associates, LLC | Assisted Living Facility | 2334 North Madison Ave, Anderson, IN 46011 | 2007-09-27 |
| 1720155187 | Garry L Smith Dds PC | Dentist | 1528 Medical Arts Blvd, Anderson, IN 46011 | 2006-11-29 |
| 1891711586 | Suzanne Obrien Beeson | Psychologist | 1210 Medical Arts. Blvd., Suite 208, Anderson, IN 46011 | 2006-07-14 |
| 1669471199 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1809 N Madison Ave, Anderson, IN 46011 | 2005-07-18 |
| 1265980742 | Andrew J Koehler | Counselor | 2010 Brentwood Dr, Anderson, IN 46011 | 2016-09-14 |
| 1902258866 | Audrey A. Dickerson | Physician Assistant | 1515 N Madison Ave, Anderson, IN 46011 | 2016-07-05 |
| 1104271790 | Mohammad Sami Bakdash | Internal Medicine | 1515 N Madison Ave, Anderson, IN 46011 | 2016-05-02 |
| Find all providers in zip 46011 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750570156 | Tina Marie Baxter | Nurse Practitioner | 720 W 8th St, Anderson, IN 46016-1206 | 2007-10-22 |
| 1184087629 | Daniel B Shepler | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2016-04-01 |
| 1780046102 | Erika Mccarty | Nurse Practitioner | 100 Healthy Way, Suite 1120, Anderson, SC 29621-7915 | 2016-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567249 | Sarah E Munson | Nurse Practitioner | 1633 N Capitol Ave Ste 680, Indianapolis, IN 46202-1281 | 2020-08-06 |
| 1598327009 | Jack Chitenje | Nurse Practitioner | 13914 Boulder Canyon Dr, Fishers, IN 46038-5361 | 2019-07-03 |
| 1750844890 | Sarah Kathleen Cherry | Nurse Practitioner | 4326 Maldenhair Dr, Indianapolis, IN 46239-9033 | 2019-04-06 |
| 1861966533 | Ethan Jevon Merkel | Nurse Practitioner | 721 W 13th St Ste 221, Jasper, IN 47546-1817 | 2019-01-16 |
| 1184103459 | Katherine Rose Ahaus | Nurse Practitioner | 1801 Senate Blvd Ste 230, Indianapolis, IN 46202-1252 | 2018-08-08 |
| 1205342235 | Outpatient Integrated Strategies, LLC | Nurse Practitioner | 12315 Hancock St Ste 24, Carmel, IN 46032-5885 | 2017-12-28 |
| 1508389990 | Healthy Body LLC | Nurse Practitioner | 2515 Ladue Ln, Fort Wayne, IN 46804-2796 | 2017-07-18 |
| 1821539818 | Heather Hedgepeth | Nurse Practitioner | 1850 State St Fl 1, New Albany, IN 47150-4990 | 2017-03-10 |
| 1386197770 | Masita Isabel Poray | Nurse Practitioner | 5435 E 16th St Ste 500, Indianapolis, IN 46218-4869 | 2016-08-02 |
| 1578978011 | Ta'mella Ferron | Nurse Practitioner | 7143 Morello Ln, Noblesville, IN 46062-8438 | 2014-06-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.