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SPARKS REGIONAL MEDICAL CENTER NPI 1669462461


NPI Information

NPI: 1669462461
Provider Name: SPARKS REGIONAL MEDICAL CENTER
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
1500 DODSON AVE
STE 125
FORT SMITH, AR
ZIP 72901
Phone: (479) 573-7960
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SPARKS REGIONAL MEDICAL CENTER is a geriatric medicine internal medicine in Fort Smith, AR. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. SPARKS REGIONAL MEDICAL CENTER NPI is 1669462461. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1500 DODSON AVE
STE 125
FORT SMITH, AR
ZIP 72901-182
Phone: (479) 573-7960
Fax: (479) 573-7961

The provider's authorized official is Rebecca Cox .
The authorized official title is Cbo Support Manager and has the following contact phone number (479) 709-7057.

The enumeration date for this NPI number is 10/24/2005 and was last updated on 6/5/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyNo
2363L00000XNurse PractitionerNo
3208VP0000XPain MedicinePain MedicineNo
4207RP1001XInternal MedicinePulmonary DiseaseNo
5207RC0000XInternal MedicineCardiovascular DiseaseNo
62084N0400XPsychiatry & NeurologyNeurologyNo
7207RH0003XInternal MedicineHematology & OncologyNo
8207RN0300XInternal MedicineNephrologyNo
9207RG0300XInternal MedicineGeriatric MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15C902MEDICARE ID-TYPE UNSPECIFIEDARKANSASGROUP NUMBER
2100698680WMEDICAIDOKLAHOMA
3150325002MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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