SPARK HEALTH AT HOME LLC NPI 1154957942

NPI Information

NPI: 1154957942
Provider Name: SPARK HEALTH AT HOME LLC

Doing Business As: PEDIATRIC DIRECT CARE

Classification: Nursing Care - 251J00000X
Entity Type: Organization

Address:
1325 S COLORADO BLVD STE B312
DENVER, CO
ZIP 80222
Phone: (720) 479-8952
Get Directions

SPARK HEALTH AT HOME LLC is a nursing care in Denver, CO. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. SPARK HEALTH AT HOME LLC NPI is 1154957942. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pediatric Direct Care.

The provider's business location address is:

1325 S COLORADO BLVD STE B312
DENVER, CO
ZIP 80222-335
Phone: (720) 479-8952
Fax: (888) 981-8064

The provider's authorized official is Suzanne Hakar .
The authorized official title is Ceo and has the following contact phone number (720) 479-8952.

The CLIA number assigned to this NPI record is 06D2188641 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2020 and was last updated on 1/5/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	104100000X	Social Worker		No
2	163W00000X	Registered Nurse		No
3	171M00000X	Case Manager/Care Coordinator		No
4	2080A0000X	Pediatrics	Adolescent Medicine	No
5	224Z00000X	Occupational Therapy Assistant		No
6	225100000X	Physical Therapist		No
7	225200000X	Physical Therapy Assistant		No
8	225X00000X	Occupational Therapist		No
9	235Z00000X	Speech-Language Pathologist		No
10	252Y00000X	Early Intervention Provider Agency		No
11	261Q00000X	Clinic/Center		No
12	261QE0002X	Clinic/Center	Emergency Care	No
13	363L00000X	Nurse Practitioner		No
14	363LP0200X	Nurse Practitioner	Pediatrics	No
15	251J00000X	Nursing Care		Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9000181113	MEDICAID	COLORADO

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

NPI Synchronization or Removal

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