Individual provider Active NPI

Kristy D Dodson, FNP-BC

  • Nurse Practitioner
  • Sparta, TN
National Provider Identifier
1619860202
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
165966 Issued in TN
Practice address
705 Howell St
Sparta, TN 38583-1057
Phone
(931) 739-0048
Fax
(931) 739-0047
NPI assigned
Jun 2, 2025
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 165966 TN Primary

Addresses

Primary practice location

705 Howell St
Sparta, TN 38583-1057

Mailing address

3406 Sparkmantown Rd
Doyle, TN 38559-3207
Phone (931) 743-3130

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250825003502 TN Practitioner - Nurse Practitioner 2668972589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TLC Family Care PCGroup PAC ID 8022022995, 3 clinicians

Practice addresses (Care Compare)

705 Howell St
Sparta, TN 38583-1008
Phone (931) 239-0048

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
165966TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Warrior Counseling, PLLC CurrentSince Jun 8, 2025 Accepting new patients
TLC Family Care PC CurrentSince Aug 7, 2025 Accepting new patients

Locations

705 Howell St
Sparta, TN 38583
Phone (931) 239-0048

Organizations & group practices 2

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1619860202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 SPARKMANTOWN RD",
            "city": "DOYLE",
            "state": "TN",
            "postal_code": "385593207",
            "telephone_number": "931-743-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HOWELL ST",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831057",
            "telephone_number": "931-739-0048",
            "fax_number": "931-739-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "KRISTY",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "165966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, TN

Sources for this page

Verify at the official NPI Registry.