DR. CHARISSE Y SPARKS MD NPI 1689694390

NPI Information

NPI: 1689694390
Provider Name: DR. CHARISSE Y SPARKS, MD
Classification: Orthopaedic Surgery - 207XX0801X
Entity Type: Individual

Specialization: Orthopaedic Trauma

Address:
1809 W LOOP 281
SUITE 100-131
LONGVIEW, TX
ZIP 75604
Phone: (816) 262-2455
Get Directions

DR. Charisse Y Sparks, MD is an orthopaedic trauma orthopaedic surgery in Longview, TX. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. DR. Charisse Y Sparks, MD NPI is 1689694390. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1809 W LOOP 281
SUITE 100-131
LONGVIEW, TX
ZIP 75604-571
Phone: (816) 262-2455

The enumeration date for this NPI number is 7/19/2006 and was last updated on 3/13/2013.

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	License Number	License State	Primary
1	207XX0801X	Orthopaedic Surgery	Orthopaedic Trauma	022981	MISSOURI	No
2	207XX0801X	Orthopaedic Surgery	Orthopaedic Trauma	P1597	TEXAS	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	7230075	OTHER	MISSOURI	AETNA
2	10001805100	OTHER	MISSOURI	CHP
3	35460011	OTHER	MISSOURI	BCBS KANSAS CITY
4	200326080A	MEDICAID	KANSAS
5	P00273060	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	RR MEDICARE
6	701D871	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI
7	719498	OTHER		PHP HEALTHLINK
8	I10093	MEDICARE UPIN	MISSOURI
9	209342302	MEDICAID	MISSOURI

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: 5/5/2024

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