Ted Ryan Sparks, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14051 Issued in TN

Practice address

109 Raytheon Rd
Bristol, TN 37620-5813

Phone

(423) 484-8488

NPI assigned

Mar 1, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

East Tennessee State University Quillen College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Watauga Orthopaedics PLCGroup PAC ID 1456246479, 85 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Watauga Orthopaedics PLC

  • Orthopaedic Surgery Physician
  • Johnson City, TN
  • NPI 1245251404
  Medicare reassignment Care Compare group
• Sparked Rehab and Athletics, PLLC

  • Physical Therapy Clinic/Center
  • Bristol, TN
  • NPI 1649979436
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1023717816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 CODY CV",
            "city": "BLUFF CITY",
            "state": "TN",
            "postal_code": "376184382",
            "telephone_number": "828-385-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 RAYTHEON RD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376205813",
            "telephone_number": "423-484-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "TED",
        "middle_name": "RYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soho Counseling PLLC
• Celeste Y Sorah
• Southeastern Pain Management Center, PLLC
• Diana Allison Souther, MS
• Sparked Rehab and Athletics, PLLC
• J. Michael Spear, M.D.
• Specialty Surgeons, P.C.
• Spine and Hand Center, PC
• Alexius Spradlin
• Mikayla Elizabeth Sprigss

• Physical Therapist in Bristol, TN
• Providers in Bristol, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.