| Chelsey Sparks Dba Decaturville Family Practice | |
|
187 W Main St Decaturville TN 38329-8078 | |
| (731) 852-2761 | |
| Not Available |
| Full Name | Chelsey Sparks Dba Decaturville Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 187 W Main St, Decaturville, Tennessee |
| Authorized Official Name and Position | Chelsey Johnson Sparks (FNP) |
| Authorized Official Contact | 7318522761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chelsey Sparks Dba Decaturville Family Practice 187 W Main St Decaturville TN 38329-8078 Ph: (731) 852-2761 | Chelsey Sparks Dba Decaturville Family Practice 187 W Main St Decaturville TN 38329-8078 Ph: (731) 852-2761 |
| NPI Number | 1730610452 |
|---|---|
| Provider Enumeration Date | 03/23/2017 |
| Last Update Date | 06/22/2022 |
| Medicare PECOS PAC ID | 3971872284 |
|---|---|
| Medicare Enrollment ID | O20170629002334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730610452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Chelsey Johnson Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295008795 PECOS PAC ID: 9830351576 Enrollment ID: I20120425000774 |
| Provider Name | Whitney Jackson Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427560531 PECOS PAC ID: 4587927538 Enrollment ID: I20180404002359 |
| Provider Name | Jillian Elizabeth Ferrari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700494895 PECOS PAC ID: 5193144376 Enrollment ID: I20211102001958 |
| Provider Name | Kristina A Hutcherson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699474528 PECOS PAC ID: 1850751926 Enrollment ID: I20230720002699 |
K. Ramesh Reddy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 187 W Main St, Decaturville, TN 38329 Phone: 731-852-2761 Fax: 731-852-2781 |