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SPARK MED SPA, LLC
NPI 1376246884
Clinic/Center - Health Service in Hayden, ID

Active since March 23, 2023
8027 N GOVERNMENT WAY, SUITE 106, HAYDEN, ID 83835(208) 241-9422 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 28, 2025, Mar 23, 2023 (2 updates tracked since 2023).

About Spark Med Spa, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPARK MED SPA, LLC (NPI 1376246884), doing business as Spark Med Spa, is a healthcare organization registered as a health service in Hayden, Idaho and active in the NPI registry since March 2023. The organization maintains a secondary practice location in Pocatello and lists Robbie J Garrett, Co-owner/director, as its authorized official.

NPPES Registry Identity

NPI1376246884
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameSPARK MED SPA, LLC
Location Address8027 N GOVERNMENT WAY, SUITE 106Hayden, ID 83835
Mailing AddressPo Box 1021Athol, ID 83801-6009 · (208) 241-9942
Phone(208) 241-9422
Organization SubpartYes
Authorized OfficialRobbie J GarrettCo-owner/director · (208) 251-2660
Enumeration DateMarch 23, 2023
Last NPPES UpdateMay 28, 20252 updates tracked since enumeration
NPPES CertifiedMay 16, 2025
✔ NPI 1376246884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
8027 N GOVERNMENT WAY, Hayden, ID 83835
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Other Names 1

Doing Business AsSpark Med Spa

Secondary Practice Location 1

Location 11352 E Center St Ste BPocatello, ID 83201-4702 · Phone (208) 241-9942

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 Spark Med Spa, LLC's NPI number?

The NPI number for Spark Med Spa, LLC is 1376246884. It was assigned to this organization in the NPPES registry on March 23, 2023. The provider is doing business as Spark Med Spa.

Where is Spark Med Spa, LLC located?

Spark Med Spa, LLC is located at 8027 N Government Way Suite 106, Hayden, ID 83835. The listed phone number is (208) 241-9422.

What is Spark Med Spa, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Spark Med Spa, LLC was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.