Spark Integrative Wellness, PLLC
NPI 1053121574 · Mental Health Clinic/Center (Including Community Mental Health Center) · Johnson City, TN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Spark Integrative Wellness, PLLC is a Mental Health Clinic/Center (Including Community Mental Health Center) organization in Johnson City, TN (NPI 1053121574).
Provider details
- NPI number
- 1053121574
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennifer Judy, Pmhnp(423) 491-9146
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-01-08
- Last updated
- 2025-01-08
- Certified
- 2025-01-08
Frequently asked questions
- What is Spark Integrative Wellness, PLLC's NPI number?
- Spark Integrative Wellness, PLLC's National Provider Identifier (NPI) is 1053121574, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Spark Integrative Wellness, PLLC?
- Spark Integrative Wellness, PLLC is classified in the NPPES registry as Mental Health Clinic/Center (Including Community Mental Health Center) (Ambulatory Health Care Facilities).
- Where is Spark Integrative Wellness, PLLC located?
- Spark Integrative Wellness, PLLC's practice location on file with NPPES is 2700 S Roan St Ste 300a, Johnson City, TN 37601-7556.
- What is Spark Integrative Wellness, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Spark Integrative Wellness, PLLC is (423) 722-2422.
- Does Spark Integrative Wellness, PLLC accept Medicare?
- Spark Integrative Wellness, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Spark Integrative Wellness, PLLC?
- The authorized official listed on Spark Integrative Wellness, PLLC's NPPES record is Jennifer Judy, Pmhnp. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Spark Integrative Wellness, PLLC's NPI active?
- Yes — Spark Integrative Wellness, PLLC's NPI (1053121574) is active in the NPPES registry as of the last update on 2025-01-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.