MRS. NICOLE LISA SPARKS PA-C
NPI 1093203697
Physician Assistant - Surgical in Eglin Afb, FL
About Mrs. Nicole Lisa Sparks Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. NICOLE LISA SPARKS PA-C (NPI 1093203697) is an individual surgical provider in Eglin Afb, Florida and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Nicole Lisa Sparks Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Nicole Sparks's NPI number?
The NPI number for Nicole Sparks is 1093203697. It was assigned to this individual provider in the NPPES registry on April 29, 2018.
Where is Nicole Sparks located?
Nicole Sparks practices at 307 Boatner Rd Ste 114, Eglin Afb, FL 32542. The listed phone number is (850) 883-8600.
What is Nicole Sparks's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Nicole Sparks enrolled in Medicare?
Yes. Nicole Sparks is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Nicole Sparks was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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. Nicole Lisa Sparks, PA-C · NPI 1093203697
Surgical physician in Eglin Afb, Florida. Individual provider, active in the CMS NPPES registry since April 29, 2018.
## Identity
- **NPI:** 1093203697 (Entity type: Individual)
- **Enumerated:** April 29, 2018
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **Sole proprietor:** No
## Practice location
- **Address:** 307 BOATNER RD STE 114, Eglin Afb, FL 32542-1302
- **Phone:** (850) 883-8600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for durable medical equipment, power mobility devices
## Record status
- **NPPES last updated:** August 1, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1093203697) · Data from the CMS NPPES public registry.