Active NPI
Chelsey Johnson Sparks, APRN-BC
- Family Nurse Practitioner
- Decaturville, TN
On this page
- Key facts
- NPPES NPI Registry
- Organizations & group practices1
- Hospital & facility affiliations6
- Other NPIs with the same Medicare PAC ID1
- Care Compare profile
- Medicare participation
- All disclosed owners & managing parties2
- National Provider Directory
- NPI Registry JSON
- Other providers in Decaturville, TN
- Sources for this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 16496
- Practice address
- 187 W Main St
Decaturville, TN 38329-8078 - Phone
- (731) 852-2761
- Fax
- (731) 852-2781
- NPI assigned
- Feb 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 16496 | TN | Primary |
Addresses
Primary practice location
187 W Main St
Decaturville, TN 38329-8078
Mailing address
115 E Brooklyn St
P O Box 916
Linden, TN 37096-3515
Phone (931) 589-2104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528159 | Medicaid | TN |
Organizations & group practices 1
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.
-
- Rural Health Clinic/Center
- Decaturville, TN
- NPI 1730610452
TN
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, TN
- NPI 1093705428
Hospital
-
- Home Health Agency
- Parsons, TN
- NPI 1396702536
-
- Home Health Agency
- Parsons, TN
- NPI 1548211717
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Rural Health Clinic/Center
- Decaturville, TN
- NPI 1730610452
3971872284
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Chelsey Sparks Dba Decaturville Family Practice
Practice addresses (Care Compare)
187 W Main St
Decaturville, TN 38329-8078
Phone (731) 852-2761
Hospital & facility affiliations
- Volunteer Homecare of West TN
- Tennessee Quality Care - Home Health
- Jackson-Madison County General Hospital
- Henderson County Community Hospital
- West Tennessee Healthcare Camden Hospital
- Hardin Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120425000774 | TN | Practitioner - Nurse Practitioner | 9830351576 | Reassigns benefits to 1 organization |
| O20200526001526 | TN | Part A Provider - Rural Health Clinic | 3971872284 | Practice locations: Decaturville, TN |
Rural health clinic certification: CCN 883826
- Legal name
- CHELSEY SPARKS DBA DECATURVILLE FAMILY PRACTICE
- Doing business as
- DECATURVILLE FAMILY PRACTICE
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Sep 9, 2020
- Last certification
- Mar 3, 2026
- Ownership / control type
- 1A
- Organization structure
- Sole Proprietor
- Enrollment address
- 187 W Main St
Decaturville, TN 38329-8078
All disclosed owners & managing parties 2
Medicare enrollment filesAs disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Andrew Sparks | 5% Or Greater Direct Ownership Interest | Jul 1, 2017 | 50% |
| Corporate Officer | Jul 1, 2017 | ||
| W-2 Managing Employee | Jul 1, 2017 | ||
| Chelsey Johnson Sparks | 5% Or Greater Direct Ownership Interest | Jul 1, 2017 | 50% |
| Corporate Officer | Jul 1, 2017 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16496 | TN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1295008795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 E BROOKLYN ST",
"address_2": "P O BOX 916",
"city": "LINDEN",
"state": "TN",
"postal_code": "370963515",
"telephone_number": "931-589-2104",
"fax_number": "931-589-2513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "187 W MAIN ST",
"city": "DECATURVILLE",
"state": "TN",
"postal_code": "383298078",
"telephone_number": "731-852-2761",
"fax_number": "731-852-2781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "CHELSEY",
"middle_name": "JOHNSON",
"credential": "APRN-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-14",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "16496",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1528159",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Decaturville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- 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.