Physician Compare National (NPI:1659325561)

HEALTHCARE PROVIDER: REBECCA C. SPARKS OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659325561
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668546359
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170105000085
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SPARKS
	Individual professional last name
Provider First Name	REBECCA
	Individual professional first name
Provider Middle Name	CATHERINE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	307 W HWY 54 100
	Group Practice or individual's line 1 address
City	ANDOVER
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	670027849
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y