MR. KELLY L. SPARKS


Address: 109 Bridge St Ste 300, Danville, VA 24541-1222
Phone: 4347934711

MR. KELLY L. SPARKS (NPI# 1649245309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649245309
Entity Type Individual
Full Name MR. KELLY L. SPARKS
Credential PA
Practice Address 109 Bridge St Ste 300
Danville
VA 24541-1222
Practice Telephone 4347934711
Practice Fax Number 4347972514
Mailing Telephone 4347934711
Mailing Fax Number 4347972514
Enumeration Date 2006-02-17
Last Update Date 2020-08-06
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363A00000X Physician Assistant 10000928A IN Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant 85080096 IL Physician Assistants & Advanced Practice Nursing Providers
N 363AM0700X Physician Assistant
Specialization: Medical
0110007007 VA Physician Assistants & Advanced Practice Nursing Providers
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
VA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
VA STATE LICENSE 0110007007 01
VA MEDICARE VVX692A 01

Other Providers KELLY SPARKS

NPI Name Taxonomy Address Enumeration
1366648651 Kelly Anne Sparks Speech-Language Pathologist 3426 S Alameda St, Corpus Christi, TX 78411-1720 2007-06-22
1073732947 Kelly Sparks Speech-Language Pathologist 4928 Cinderwood Dr, Yukon, OK 73099-2118 2007-04-25
1154699882 Kelly Sparks Dietitian, Registered 1 Gustave L Levy Pl, Box 1104, New York, NY 10029-6500 2011-12-08

Office Location

Street Address 109 BRIDGE ST STE 300
City DANVILLE
State VA
Zip Code 24541-1222

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396344156 Heath Hylton Physical Therapy Assistant 109 Bridge St Ste 300, Danville, VA 24541-1222 2020-10-22
1467950709 Rachel N Gunnell Physical Therapist 109 Bridge St Ste 300, Danville, VA 24541-1222 2018-01-31
1265861389 John Ross Wilkinson Physical Therapist 109 Bridge St Ste 300, Danville, VA 24541-1222 2013-11-08
1063760569 Patti Pierce Snead Physical Therapist 109 Bridge St Ste 300, Danville, VA 24541-1222 2012-08-15
1720308471 James Adam Dailey Physical Medicine & Rehabilitation 109 Bridge St Ste 300, Danville, VA 24541-1222 2010-06-04
1245562073 Leslie Coleman Lovelace Physical Therapist 109 Bridge St Ste 300, Danville, VA 24541-1222 2010-02-04
1174767537 Jennifer Davis Physical Therapist 109 Bridge St Ste 300, Danville, VA 24541-1222 2009-04-28
1801045356 Stephan H Jannach Family Medicine 109 Bridge St Ste 300, Danville, VA 24541-1222 2008-09-09
1326208604 Spectrum Medical Inc Physical Therapist 109 Bridge St Ste 300, Danville, VA 24541-1222 2008-06-11
1467644435 Sharukh Darius Shroff Internal Medicine 109 Bridge St Ste 300, Danville, VA 24541-1222 2007-08-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1104303551 Damon Lee Simpson Occupational Therapy Assistant 1616 Maple Dr, Danville, VA 24541 2018-07-27
1578065041 Strategic Therapy Associates, Inc. Transportation Broker 1225 W Main Street, Danville, VA 24541 2018-03-01
1790291078 Vicente T Falgui Md PC Internal Medicine 990 Main Street, Suite 204, Danville, VT 24541 2017-12-21
1558884270 Focus Point Mental Health, LLC Community/Behavioral Health 116 Magnolia Drive, Danville, VA 24541 2017-07-25
1073045522 Brittney Paige Throckmorton-samples Physical Therapist 174 Executive Drive, Danville, VA 24541 2017-04-03
1114378106 Laurie Rich Taylor Nurse Practitioner 541 Bridge Street, Suite 1, Danville, VA 24541 2016-06-30
1285085779 Larry Keller Counselor 1555 Meadowview Dr Ste 5, Danville, VA 24541 2016-06-25
1952617474 Joshua Home Family Services Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 223 Randolph Street, Danville, VA 24541 2010-08-21
1922274661 Blankenship & Davis Opticians Inc Eyewear Supplier (Equipment, not the service) 625 West Main Street, Danville, VA 24541 2008-05-02
1750588307 Tiffany Devon Clark Physical Therapy Assistant 432 Hermitage Dr., Danville, VA 24541 2007-06-28
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629589981 Bryce Alden Petersheim Physician Assistant 100 N Academy Ave, Danville, PA 17822-9800 2017-10-13
1780076919 Lauren B. Peters Physician Assistant 115 Woodbine Ln, Danville, PA 17822-5212 2015-02-25
1295921732 Heather D Letcavage Physician Assistant 115 Woodbine Ln, Danville, PA 17821-9118 2007-09-19
1699737585 Wayne Thomas Wing Physician Assistant 1900 E Main St, Surgical Service, Danville, IL 61832-5100 2006-04-05

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1962038042 Emma Alexandra Rouse Physician Assistant 2712 Hatmark St, Vienna, VA 22181-6054 2020-03-20
1861059461 Daniel P Sherman Physician Assistant 43165 Thistledown Ter Apt 241, Broadlands, VA 20148-4075 2019-05-20
1184289753 Vicenta Hanh-phuoc Tran Physician Assistant 7611 Trammell Rd, Annandale, VA 22003-1442 2019-05-08
1649833021 Karlie Diruzza Physician Assistant 2900 Lamb Cir # L760, Christiansburg, VA 24073-6344 2019-04-21
1164983599 Bradley Pretzer Physician Assistant 5115 Cliffhaven Dr, Annandale, VA 22003-4348 2019-03-28
1346757416 Hinda Yasmin Mezaache Physician Assistant 1101 Sam Perry Blvd Ste 219, Fredericksburg, VA 22401-4465 2018-01-10
1265974851 Gerard Surgical Services, LLC Physician Assistant 12220 Chattanooga Plz Ste 121, Midlothian, VA 23112-4865 2016-11-14
1417301607 Jose Gustavo Espino Physician Assistant 6866 Deer Run Dr, Alexandria, VA 22306-1124 2016-04-14
1477915098 Kelly Egan Weaver Physician Assistant 1201 Broad Rock Blvd Richmond Va 23224, Richmond, VA 23249-4915 2016-03-23
1871976522 Hall Surgical Assistance, LLC Physician Assistant 10332 Main St, Suite #344, Fairfax, VA 22030-2410 2015-06-30
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Competitor

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City DANVILLE
Zip Code 24541

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Dataset Information

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.

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