DR. RANDAL P SPARKS (NPI# 1831201144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831201144 |
| Entity Type | Individual |
| Full Name | DR. RANDAL P SPARKS |
| Credential | DO |
| Practice Address |
600 East Fairview Avenue Olivia MN 56277-1399 |
| Mailing Address |
600 E Park Ave Olivia MN 56277-1370 |
| Practice Telephone | 3205231460 |
| Mailing Telephone | 3205231460 |
| Mailing Fax Number | 3205231703 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 52538 | MN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | DO-437 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 529402090 | 05 | |
| UNITED HEALTHCARE | 0110005 | 01 | |
| AL | BLUE CROSS BLUE SHIELD | 51028285 | 01 |
| CIGNA | 6309683290010 | 01 | |
| AETNA | 0004119242 | 01 |
| Street Address |
600 EAST FAIRVIEW AVENUE |
| City | OLIVIA |
| State | MN |
| Zip Code | 56277-1399 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720632276 | William Cleveland | Pharmacist | 105 S 1st Street, Olivia, MN 56277 | 2019-08-01 |
| 1386172633 | Healing Transformations Counseling Pllc | Social Worker | 1635 West Lincoln Avenue, Suite 3, Olivia, MN 56277 | 2017-05-31 |
| 1053455774 | Sward-kemp Drug Co of Olivia Inc | Pharmacy | 801 East Depue Avenue, Olivia, MN 56277 | 2007-02-16 |
| 1073678959 | Independent School District No 2534 | Local Education Agency (LEA) | 701 South 9th Street, Olivia, MN 56277 | 2006-12-22 |
| 1669488466 | Olivia Ambulance Service, Inc. | Ambulance | 1005 W Lincoln Ave, Olivia, MN 56277 | 2006-08-01 |
| 1619303682 | Rebecca M Thiesse | Audiologist | 600 E Park Ave, Ste 2, Olivia, MN 56277 | 2013-09-22 |
| 1871746164 | Lisa Lora Babler | Physician Assistant | 611 E Fairview Ave, Olivia, MN 56277 | 2008-10-30 |
| 1679667554 | Bruce B Neumann | Podiatrist | 100 Healthy Way, Olivia, MN 56277 | 2006-10-03 |
| 1982655270 | Ggnsc Olivia LLC | Skilled Nursing Facility | 1003 W Maple Ave, Olivia, MN 56277-1063 | 2006-05-12 |
| 1093337800 | Renville Olivia Holdings | Skilled Nursing Facility | 1003 W Maple Ave, Olivia, MN 56277-1063 | 2020-05-14 |
| Find all providers in zip 56277 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295399251 | Roberta Lynn Kopel | Family Medicine | 1605 W Lincoln Ave, Olivia, MN 56277-1260 | 2019-04-25 |
| 1992784011 | Muhamed Huso Durakovic | Family Medicine | 611 E Fairview Ave, Olivia, MN 56277-1397 | 2006-01-17 |
| 1134779747 | Kelli Ann Craven | Family Medicine | 100 Healthy Way, Olivia, MN 56277-1117 | 2019-09-16 |
| 1568846871 | April Pisano | Family Medicine | 611 E Fairview Ave, Olivia, MN 56277-4213 | 2015-07-16 |
| 1942646765 | Benjamin August Linder | Family Medicine | 100 Healthy Way, Olivia, MN 56277-1117 | 2013-05-20 |
| 1225471741 | Carin Marie Martinson | Family Medicine | 100 Healthy Way, Olivia, MN 56277-1117 | 2013-04-15 |
| 1477514669 | Borney Brian Tilby | Family Medicine | 600 E Park Ave, Olivia, MN 56277-1370 | 2006-03-29 |
| 1033179676 | Nazita Adili-khams | Family Medicine | 600 E Park Ave, Olivia, MN 56277-1370 | 2006-03-27 |
| 1679549992 | Jon R Kemp | Family Medicine | 611 E Fairview Ave, Olivia, MN 56277-4213 | 2006-02-27 |
| 1972579696 | Jeffrey T Krogstad | Family Medicine | 611 E Fairview Ave, Olivia, MN 56277-4213 | 2006-02-23 |
| Find all providers in OLIVIA | ||||
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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.