Tier 1 Orthopedic and Neurosurgical Institute

What Tier 1 Orthopedic and Neurosurgical Institute does

Tier 1 Orthopedic and Neurosurgical Institute is a private, multi-specialty medical practice headquartered in Cookeville, Tennessee, delivering orthopedic, neurosurgical, sports medicine, interventional pain management, physical therapy, and urgent care services across five state-of-the-art facilities in the Upper Cumberland region of Tennessee (Cookeville, Crossville, McMinnville, Sparta, Livingston, and Carthage). Founded in 1976 by Dr. Sam Barnes and now operating as a member of the Campbell Clinic family, the practice staffs 15 physicians with credentials from Mayo Clinic, Vanderbilt, Campbell Clinic, and other leading institutions, supported by physician assistants, nurse practitioners, physical therapists, and administrative staff. The November 2025 opening of the Tier 1 Surgery Center, an AAAHC-accredited freestanding outpatient facility, completes a vertically integrated care model that includes on-site MRI, in-house physical therapy, and orthopedic urgent care.

The practice's service portfolio spans the full musculoskeletal care continuum: arthroscopic and minimally invasive surgery, robot-assisted joint replacement (knee, hip, ankle), spine surgery including discectomy, fusion, and kyphoplasty, brain and spine neurosurgery, fracture care, interventional pain management (epidural steroid injections, radiofrequency ablation, kyphoplasty, spinal cord stimulation), and sports medicine with PRP injections. Diagnostic infrastructure includes on-site MRI at the Tier 1 North Building and X-ray, with same-day imaging frequently available alongside physician visits. The patient-facing technology stack uses athenahealth for the patient portal (registration, medical history, refills, bill pay, messaging) and Sharecare for medical records requests. No AI/ML capabilities are disclosed.

Tier 1 generates revenue on a fee-for-service basis through patient services and insurance reimbursement. Pricing is either a comprehensive fee covering all physician time for major injuries and surgery, or per-visit fees for less severe problems, with separate charges for X-rays, injections, crutches, splints, and casts. The practice accepts major payers including Medicare, Medicare Advantage, Blue Cross PPO, Cigna PPO, United Healthcare, PHCS, First Health, Blue Grass Family Health, Prime, Workers Compensation, and Humana Medicare products, and is partnered with Cookeville Regional Medical Center for hospital-based admissions. Patient acquisition is direct-to-consumer via online booking and a referral channel from primary care physicians, supported by a website, Facebook presence, and online appointment request forms processed within two business days.

Name

Tier 1 Orthopedic and Neurosurgical Institute

Legal name

Tier 1 Orthopedic and Neurosurgical Institute

Website

https://t1institute.com

Company type

Private

Founded year

1976

Operating status

Operating

Headcount range

51–100 employees

Short description

Tier 1 Orthopedic and Neurosurgical Institute is a private multi-specialty medical practice in Cookeville, Tennessee, delivering orthopedic, neurosurgical, sports medicine, pain management, physical therapy, and urgent care across five facilities in the Upper Cumberland region. It serves the general public via a fee-for-service model and integrates in-house MRI, physical therapy, and an AAAHC-accredited surgery center.

Ownership category

akta.pro rank

Product category

Orthopedic and Neurosurgical Healthcare Services

NAICS

Freestanding Ambulatory Surgical and Emergency Centers (621493), Offices of Physical, Occupational and Speech Therapists, and Audiologists (621340), Diagnostic Imaging Centers (621512)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Specialty Outpatient Facilities, Nec (8093), Services-Health Services (8000)

akta.pro primary industry

General Orthopedics (HLAKALAA)

akta.pro secondary industries

Orthopedic Surgery (Operative Orthopedics) (HLAKALAC), Spine (Orthopedic Spine) (HLAKALAE), Orthopedic & Spine Surgery Centers (HLAFAIAG)

Keywords

• Orthopedic medical services
• Neurosurgical care
• Sports medicine treatment
• Physical therapy rehabilitation
• Joint replacement surgery

Headquarters

HQ city

Cookeville

HQ country

United States

HQ region

North America

Offices10 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Technology or R&D, Marketing or Sales

Revenue model

1. Patient Services Revenue: Fee-for-service healthcare revenue from medical consultations, procedures, surgeries, diagnostic imaging, and physical therapy services. Charges include either a comprehensive fee for major injuries/surgery covering all physician time, or per-visit fees for less severe problems. Additional charges for X-rays, injections, crutches, splints, and casts separate from office visit fees. Insurance claim forms submitted within 10 days of receipt.
2. Insurance/Reimbursement: Revenue from insurance payers including Medicare (traditional), Medicare Advantage plans, Blue Cross PPO, Cigna PPO, United Healthcare, PHCS, First Health, Blue Grass Family Health, Prime, Workers Compensation, and Humana Medicare HMO/POS/PPO/PFFS. Health insurance is processed and submitted by the practice.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Tier 1 Orthopedic and Neurosurgical Institute delivers comprehensive musculoskeletal and neurological care through a multispecialty medical practice. Core services span orthopedic surgery (joint replacement, fracture care, sports medicine), neurosurgery (spine and brain surgery), interventional pain management, physical therapy and rehabilitation, walk-in orthopedic urgent care, and on-site diagnostic MRI — all delivered across five state-of-the-art facilities anchored by a freestanding AAAHC-accredited outpatient surgery center.

Product overview

Tier 1 Orthopedic and Neurosurgical Institute is a multispecialty medical practice offering a comprehensive array of orthopedic, neurosurgical, sports medicine, interventional pain management, and physical therapy services. The practice operates five state-of-the-art facilities throughout the Upper Cumberland region and includes an on-site MRI, a dedicated surgery center, and in-house physical therapy. The core offerings include Orthopedic Services (joint replacement, fracture care, sports medicine), Neurosurgery Services (spine surgery, brain surgery), Physical Therapy and Rehabilitation Services, Interventional Pain Management, and Orthopedic Urgent Care. The practice was founded in 1976 and is now part of the Campbell Clinic family.

Differentiator

Problem solved

Functional benefit

Products and services

• Orthopedic Services

Quantifiable outcome

• Same-day MRI scheduling available
• +1 more outcomes

Named customers2 records

Segments2 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Three partnerships are on record, tiered core.

• Campbell CliniccoreStrategic or Co-development PartnerTier 1 Institute is now a member of the Campbell Clinic family. Campbell Clinic is a renowned orthopedic practice based in Memphis, Tennessee, associated with the University of Tennessee Health Science Center. This partnership provides access to broader orthopedic expertise and resources.
• SharecarecoreTechnology or IntegrationCampbell Clinic – Tier 1 Orthopedic and Neurosurgical Institute has partnered with Sharecare to fulfill requests for medical records. Sharecare provides the platform for electronic medical records requests, third-party requester submissions, and FMLA/Disability form processing.
• Cookeville Regional Medical Center (CRMC)coreStrategic or Co-development PartnerPrimary hospital partner for patient hospitalization. Neurosurgical patients admitted to CRMC with continued care from Tier 1 physicians. CRMC has undergone rapid growth in specialty surgical services including vascular surgery, cardiac surgery, and plastic surgery, complementing orthopedic and neurosurgical practices.

Scale indicators5 records

Recent moves8 records

Expansion highlights5 records

Regional players

• Carilion Clinic Orthopaedics: Integrated health system with orthopedic service line operating in western Virginia. Comparable as a multi-specialty orthopedic program with surgical, rehabilitation, and imaging capabilities, but operates in a different geographic catchment area.

Broad incumbents

• TriStar Health (HCA Healthcare): Hospital system operating multiple facilities across Middle Tennessee with orthopedic service lines. Broad incumbent competitor for inpatient surgical cases and a potential partner/acquirer of independent orthopedic groups in the region.
• Vanderbilt Orthopaedics: Academic orthopedic program at Vanderbilt University Medical Center in Nashville offering comprehensive orthopedic subspecialty care. Comparable service breadth but competes as a tertiary/academic referral destination rather than a community practice.
• Surgery Partners: Public operator of ambulatory surgical centers and surgical hospitals, including orthopedic-focused facilities. Comparable given Tier 1's launch of its own AAAHC-accredited ASC; relevant for understanding facility economics and competitive ASC operators in similar markets.
• US Orthopedic Partners: Orthopedic management services organization partnering with orthopedic practices across the Southeast. Comparable as an orthopedic group consolidator; relevant given Tier 1 has joined the Campbell Clinic family and may evaluate similar affiliation paths.

Direct peers

• Hughston Clinic: Specialty orthopedic practice with national footprint historically focused on sports medicine, trauma, and joint replacement. Comparable as a multi-physician orthopedic specialty group with surgical and rehabilitation services.
• OrthoCarolina: One of the largest independent orthopedic practices in the United States, headquartered in Charlotte, NC with multiple specialty service lines including spine, sports medicine, and joint replacement. Closely comparable large multi-specialty orthopedic group with in-house imaging and therapy.
• Campbell Clinic: Parent organization of Tier 1 since 2025 and a renowned multi-subspecialty orthopedic group based in Memphis, TN affiliated with the University of Tennessee Health Science Center. Directly comparable multi-specialty orthopedic practice with surgery center, PT, imaging, and sports medicine capabilities.
• Resurgens Orthopaedics: Large multi-specialty orthopedic practice in Georgia with more than 100 physicians across multiple locations. Directly comparable as a large multi-specialty orthopedic group offering joint replacement, spine, sports medicine, PT and imaging.
• Tennessee Orthopaedic Alliance: Largest orthopedic specialty group in Tennessee with multiple locations across Nashville, Middle Tennessee and surrounding regions. Directly comparable multi-specialty orthopedic practice with in-house PT, MRI, and urgent care competing for the same patient demographics.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/T1institute
• LinkedInlinkedin.com/company/tier-1-orthopedic-and-neurosurgical-institute

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Tier 1 Orthopedic and Neurosurgical Institute