104 Tennessee companies land on prestigious Inc. 5000 list
Nashville-headquartered Main Street Health was named America's #1 fastest-growing private business in 2026, experiencing 546,533% growth in its revenue in the past three years.
Nashville-headquartered Main Street Health was named America’s #1 fastest-growing private business in 2026, posting 546,533% revenue growth.
Tennessee had a strong showing on this year’s Inc. 5000, one of the most prestigious rankings in American business, with 104 companies statewide making the cut among the nation’s fastest-growing private companies.
The list spans healthcare, technology, logistics and entertainment, and Tennessee’s honorees combined for $12.9 billion in total revenue and 35,965 employees.
Nashville-headquartered company tops list at #1
Topping the list this year is a Nashville-based company: Main Street Health. The company bills itself as the country’s biggest player in value-based rural healthcare. It teams up with independent practices, rural clinics, hospitals and health systems, giving them extra staffing support and data tools to help manage patient care under a value-based model. Launched in 2021, the company achieved 546,533% growth over the last three years.
The firm, launched by health care executive Brad Smith, makes money on the savings it achieves for insurance companies. Also, a fun fact: Smith is the only entrepreneur in the last 25 years to found two different companies that ranked No. 1 on the Inc. 5000 list. His first company, CareBridge, topped the list in 2023.
More from Middle Tennessee
Seventy-two of the Tennessee companies on the Inc. 5000 list are headquartered in the Nashville metropolitan area. Some of those companies include Arcadia, Apartment Insiders, Qckbot, Conduit Security, Humani HR, and RxLogic… the list goes on and on.
Coming in from Crossville, Telling Ministries made the list at #1,843 with 188% growth.
Callouts from East Tennessee
In East Tennessee, several companies are repeating their success on the Inc. 5000 list for the second, third or fourth time.
In Chattanooga, Firecrown Media is making Gig City proud. Coming in at #307 on the list, the company operates a network of more than 50 media brands spanning aviation, marine, hobby and supply chain, reaching a monthly audience of more than 20 million and over 1 million print and digital subscribers.
RocketCert made the Inc. 5000 list for the second time in a row. Founded in 2020 in Knoxville, the company is an online learning provider helping individuals and businesses gain the education needed to obtain or renew licenses and certifications. It experienced 161% growth over the past three years.
For the sixth consecutive year, Knoxville-based Avero Advisors scored the #2,114 spot. The consultancy is modernizing the way public agencies operate internally and making it simpler for the public to interact with government. It experienced 160% growth over the past three years.
More from East Tennessee
Some of the other listed Knoxville companies include Functional Pathways, RevitalyzeMD, Garza Law Firm, Axle Logistics, KaTom Restaurant Supply, True Metal Supply and Vanterra Foundation Solutions.
Some of the other listed Chattanooga companies include Tidalwave Holdings, Big Sky Landscapes, Moca Logistics, Wyre Technology and American Logistics.
Read the full inc. 5000 list here.
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