MEDICARE: AMY SPARKS R.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian		NC

General Provider Information

NPI Number	:	1659778082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY SPARKS R.D.

Provider Business Mailing Address
First Line	:	8416 WREN CREEK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-6176
Country	:	US
Telephone Number	:	704-944-3109
Fax Number	:

Provider Business Practice Location Address
First Line	:	15720 BRIXHAM HILL AVE
Second Line	:	SUITE 300
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-4651
Country	:	US
Telephone Number	:	704-944-3109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2014
Last Update Date	:	12/01/2014

Similar Medicare Providers

1104708734 — RANDI LEE PRITCHARD
Practice Location Address:

15720 BRIXHAM HILL AVE STE 388
CHARLOTTE, NC
28277-4651

Practice Phone: 980-407-7336
Practice Fax:

1881142172 — MARRIAGE MATES
Practice Location Address:

15720 BRIXHAM HILL AVE , SUITE 30028277
CHARLOTTE, NC
28277-4651

Practice Phone: 704-464-5132
Practice Fax:

1346483856 — SUSAN GRAY SHIRLEY ARNP
Practice Location Address:

4651 CHARLOTTE PARK DR , SUITE 300
CHARLOTTE, NC
28217-1956

Practice Phone: 813-977-2777
Practice Fax:

1023386067 — ANTRANIQUE NEBLETT MSW. LCSW
Practice Location Address:

4651 CHARLOTTE PARK DR , 101C
CHARLOTTE, NC
28217-1916

Practice Phone: 704-251-5146
Practice Fax: 844-331-1422

1487995387 — MR. BANG DUONG L.C.S.W
Practice Location Address:

4651 CHARLOTTE PARK DR , SUITE 101 E
CHARLOTTE, NC
28217-1956

Practice Phone: 704-323-6988
Practice Fax:

1407296510 — ANTRANIQUE NEBLETT, LCSW
Practice Location Address:

4651 CHARLOTTE PARK DR , SUITE 101-E
CHARLOTTE, NC
28217-1956

Practice Phone: 704-251-5146
Practice Fax:

Directions to “ AMY SPARKS R.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.