Organization Active NPI

GTW, LLC

Doing business as Tristar Family Care

  • Primary Care Clinic/Center
  • Huntingdon, TN
National Provider Identifier
1104571405
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GTW, LLC
Doing business as
Tristar Family Care
Practice address
126 W Paris St
Huntingdon, TN 38344-3608
Phone
(731) 535-3600
Fax
(731) 535-3603
NPI assigned
Feb 15, 2022
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Kay Page
Title
Credentialing Manager
Phone
(731) 693-3465

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

126 W Paris St
Huntingdon, TN 38344-3608

Mailing address

PO Box 506
Huntingdon, TN 38344-0506
Phone (731) 431-2579

Other identifiers 1

IdentifierTypeStateIssuer
Q071950MedicaidTN

Other names 1

  • TRISTAR FAMILY CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220427000244 TN Part B Supplier - Clinic/Group Practice 9537556378 Receives reassigned benefits from 3 practitioners
Practice locations: Huntingdon, TN

National Provider Directory

National Provider Directory

Locations

126 W Paris St
Huntingdon, TN 38344
Phone (731) 431-2579

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1104571405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383440506",
            "telephone_number": "731-431-2579",
            "fax_number": "731-499-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W PARIS ST",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383443608",
            "telephone_number": "731-535-3600",
            "fax_number": "731-535-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GTW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "731-693-3465"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q071950",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRISTAR FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TRISTAR FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntingdon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.