Healthcare Provider Details

I. General information

NPI: 1699222398
Provider Name (Legal Business Name): LINDSAY MEGAN SPARKS R.D., L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3623 SOUTH AVE
SPRINGFIELD MO
65807-5220
US

IV. Provider business mailing address

278 BRISTLECONE DR
OZARK MO
65721-9573
US

V. Phone/Fax

Practice location:
  • Phone: 417-319-4281
  • Fax:
Mailing address:
  • Phone: 417-365-1998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2023004823
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: