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SAMUEL STARK DO
NPI 1376489807
Student in an Organized Health Care Education/Training Program in Johnson City, TN

Active since April 27, 2026
400 N STATE OF FRANKLIN RD STE 7303, JOHNSON CITY, TN 37604(423) 439-8805(423) 439-6259 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samuel Stark Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL STARK DO (NPI 1376489807) is an individual student in an organized health care education/training program in Johnson City, Tennessee and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1376489807
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSAMUEL STARKCredential: DO
Location Address400 N STATE OF FRANKLIN RD STE 7303Johnson City, TN 37604-6035
Mailing Address400 N State Of Franklin Rd Ste 7303Johnson City, TN 37604-6035 · (423) 439-8805 · Fax (423) 439-6259
Phone(423) 439-8805
Fax(423) 439-6259
Sole ProprietorNo
Enumeration DateApril 27, 2026
NPPES CertifiedApril 27, 2026
✔ NPI 1376489807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
400 N STATE OF FRANKLIN RD STE 7303, Johnson City, TN 37604
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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HANNAH CHRISTINE GUSTAFSON DO
Student in an Organized Health Care Education/Training Program
400 N STATE OF FRANKLIN RD STE 7303
JOHNSON CITY, TN 37604
Washington County (423) 439-8805
STEPHEN ROBERTS
Student in an Organized Health Care Education/Training Program
400 N STATE OF FRANKLIN RD STE 7303
JOHNSON CITY, TN 37604
Washington County (423) 439-8805
REBECCA TAYLOR
Student in an Organized Health Care Education/Training Program
400 N STATE OF FRANKLIN RD STE 7303
JOHNSON CITY, TN 37604
Washington County (423) 439-8805
JOHN MARTIN SISSON DO
Student in an Organized Health Care Education/Training Program
400 N STATE OF FRANKLIN RD STE 7303
JOHNSON CITY, TN 37604
Washington County (423) 439-8805
PATRICK HOLLOWAY BLYTHE
Student in an Organized Health Care Education/Training Program
400 N STATE OF FRANKLIN RD STE 7303
JOHNSON CITY, TN 37604
Washington County (423) 439-8805
DR. JOHN COONEY DO
Student in an Organized Health Care Education/Training Program
400 N STATE OF FRANKLIN RD STE 7303
JOHNSON CITY, TN 37604
Washington County (423) 439-8805

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Stark's NPI number?

The NPI number for Samuel Stark is 1376489807. It was assigned to this individual provider in the NPPES registry on April 27, 2026.

Where is Samuel Stark located?

Samuel Stark practices at 400 N State Of Franklin Rd Ste 7303, Johnson City, TN 37604. The listed phone number is (423) 439-8805.

What is Samuel Stark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Samuel Stark was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.