SHELLY RENAE SPARKS (NP) – Gerontology Nurse Practitioner, NPI 1962420109

SHELLY RENAE SPARKS (NP) is a healthcare provider. based in Anderson, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 71001150A (IN). The NPI Number for SHELLY RENAE SPARKS (NP) is 1962420109

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
SHELLY RENAE SPARKS (NP)
NPI
1962420109
Phone
(765) 648-4138
Address
141 W 22nd St Ste 212
Enumeration Date
17 July 2006
Last Update Date
26 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7652984242
Graduation Year
2001 (25 years ago)
PAC ID
1951462654
Group Practice PAC ID
1759416662
Professional Enrollment ID
I20081212000101
Address ID
IN460113453AN1515XAVEX400

Contacts

Secure Messaging
ssparks329282@eCommunityDirect.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

8,191 NURSE PRACTITIONER in IN

Provider Addresses for SHELLY RENAE SPARKS (NP)

  • 141 W 22nd St Ste 212

    Anderson, IN 460164389

    Phone: (765) 648-4138

    Type: Location

  • 8890 E 116th St Ste 305

    Fishers, IN 460382856

    Phone: (317) 621-6696

    Fax: (317) 621-6697

    Type: Location

  • 1515 N MADISON AVE

    ANDERSON, IN 460113453

    Phone: (317) 621-4900

    Type: Location

  • 8840, Commerce Park Place, Indianapolis, Indiana, 46268, United States

    INDIANAPOLIS, IN 462683129

    Phone:

    Type: Mailing

  • Medical Arts Boulevard, Forest Hills, Anderson, Madison County, Indiana, 46016, United States

    ANDERSON, IN 460113461

    Phone: (765) 298-1792

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-12-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081212000101INurse PractitionerINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes9590$0
99497Advance care planning, first 30 minutes4846$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes3932$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes2320$0
99221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 46016)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759416662View full group profile

Reviews

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Frequently asked questions

How is SHELLY RENAE SPARKS (NP) identified in CMS data?
CMS-hosted NPPES data lists SHELLY RENAE SPARKS (NP) with NPI 1962420109.
Is SHELLY RENAE SPARKS (NP) listed as active for patients and plans?
The listing shows SHELLY RENAE SPARKS (NP) as active in the NPI system.
What taxonomy line describes SHELLY RENAE SPARKS (NP)?
For research purposes, treat SHELLY RENAE SPARKS (NP) as Gerontology Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for SHELLY RENAE SPARKS (NP)?
SHELLY RENAE SPARKS (NP)'s geographic hint is Anderson, Indiana in our summary view.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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