MRS. KELLY SPARKS MACCCSLP
NPI 1073732947
Speech-Language Pathologist in Yukon, OK
About Mrs. Kelly Sparks Macccslp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KELLY SPARKS MACCCSLP (NPI 1073732947) is an individual speech-language pathologist provider in Yukon, Oklahoma, licensed in Oklahoma (2975) and active in the NPI registry since April 2007. She is a graduate of Other (2000).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Kelly Sparks Macccslp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelly Sparks reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lake Charles, LA 70601
- Reassigned Medicare billing, Oklahoma enrollment
- 30 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Sparks's NPI number?
The NPI number for Kelly Sparks is 1073732947. It was assigned to this individual provider in the NPPES registry on April 25, 2007.
Where is Kelly Sparks located?
Kelly Sparks practices at 4928 Cinderwood Dr, Yukon, OK 73099. The listed phone number is (405) 350-2654.
What is Kelly Sparks's specialty?
The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.
Is Kelly Sparks enrolled in Medicare?
Yes. Kelly Sparks is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelly Sparks's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Sparks reassigns Medicare benefits to Synergy Care Southeast, LLC (Lake Charles, LA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Sparks's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelly Sparks was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Kelly Sparks, MACCCSLP · NPI 1073732947
Speech-Language Pathologist provider in Yukon, Oklahoma. Individual provider, active in the CMS NPPES registry since April 25, 2007.
## Identity
- **NPI:** 1073732947 (Entity type: Individual)
- **Enumerated:** April 25, 2007
- **Primary specialty:** Speech-Language Pathologist · taxonomy 235Z00000X
- **State license:** 2975 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 4928 CINDERWOOD DR, Yukon, OK 73099-2118
- **Phone:** (405) 350-2654
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Synergy Care Southeast, LLC (NPI 1427466614, Lake Charles, LA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2000
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1073732947) · Data from the CMS NPPES public registry.