Individual provider Active NPI

Tommy A Sparks, NP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1720461379
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20218 Issued in TN
Practice address
303 Med Tech Pkwy Ste 200
Johnson City, TN 37604
Phone
(423) 794-3040
Fax
(423) 794-3041
NPI assigned
Jul 1, 2015
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024172706 VA
Family Nurse Practitioner 363LF0000X 20218 TN Primary

Addresses

Primary practice location

303 Med Tech Pkwy Ste 200
Johnson City, TN 37604

Mailing address

PO Box 632476
Cincinnati, OH 45263-2476
Phone (423) 794-3040

Other practice location 1

280 Virginia Ave NE
Suite 107
Norton, VA 24273-1538
Phone (276) 679-5390

Other identifiers 1

IdentifierTypeStateIssuer
Q014759MedicaidTN

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
I20150820011445 TN Practitioner - Nurse Practitioner 5092960344 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Suite 300E
Bristol, TN 37620-7497
Phone (423) 434-6300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20218TNMDFamily Nurse Practitioner
0024172706VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC CurrentSince Jul 1, 2025 Accepting new patients
State of Franklin Healthcare Associates PLLC CurrentSince Oct 1, 2018 Accepting new patients
Medical Education Assistance Corporation CurrentSince Jul 1, 2025 Accepting new patients
Campbell Clinic PC CurrentSince Jul 1, 2025 Accepting new patients
Medical Specialists of Johnson City PastSince Oct 1, 2018 Accepting new patients
Campbell Clinic Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 300E
Bristol, TN 37620
Phone (423) 245-3161

303 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 282-5611

303 Med Tech Pkwy
Ste 200
Johnson City, TN 37604
Phone (423) 794-3040

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

329 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tommy.sparks.1@1366.direct.athenahealth.com

Organizations & group practices 7

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 1

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1720461379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632476",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632476",
            "telephone_number": "423-794-3040",
            "fax_number": "423-794-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MED TECH PKWY STE 200",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-794-3040",
            "fax_number": "423-794-3041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Virginia Ave NE",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731538",
            "country_code": "US",
            "telephone_number": "276-679-5390",
            "fax_number": "276-679-5395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "TOMMY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172706",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q014759",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.