Sparked Rehab and Athletics, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SPARKED REHAB AND ATHLETICS, PLLC

Practice address

109 Raytheon Rd
Bristol, TN 37620-5813

Phone

(423) 484-8488

NPI assigned

Mar 1, 2023

Organization subpart

No

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

Authorized official

Name

Ted Ryan Sparks, PT, DPTNPI 1023717816

Title

Owner, Physical Therapist

Phone

(423) 484-8488

Specialties & licenses 1

Addresses

Other names 1

• Sparks Rehab and Athletics, PLLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ted Ryan Sparks, PT, DPT

  • Physical Therapist
  • Bristol, TN
  • NPI 1023717816
  NPD Authorized official

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1649979436",
    "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": {
        "organization_name": "SPARKED REHAB AND ATHLETICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "423-484-8488",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sparks Rehab and Athletics, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Matthew Raphael Snyder, D.D.S.
• Soho Counseling PLLC
• Celeste Y Sorah
• Southeastern Pain Management Center, PLLC
• Diana Allison Souther, MS
• Ted Ryan Sparks, PT, DPT
• J. Michael Spear, M.D.
• Specialty Surgeons, P.C.
• Spine and Hand Center, PC
• Alexius Spradlin

• Physical Therapy Clinic/Center in Bristol, TN
• Providers in Bristol, TN by specialty
• Physical Therapy Clinic/Center 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.