Individual provider Active NPI

Kristi H Roland, DPT

  • Orthopedic Physical Therapist
  • Madison, TN
National Provider Identifier
1164498382
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT7382 Issued in TN
Practice address
2021 Gallatin Pike N
Suite 248
Madison, TN 37115-2097
Phone
(615) 859-0351
Fax
(615) 859-0354
NPI assigned
Feb 27, 2006
Last updated
Oct 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT7382 TN Primary

Addresses

Primary practice location

2021 Gallatin Pike N
Suite 248
Madison, TN 37115-2097

Mailing address

114 Captains Cir
Hendersonville, TN 37075-6732
Phone (615) 859-0351

Other identifiers 1

IdentifierTypeStateIssuer
3646335MedicaidTN

Other names 1

  • Ms. Kristi A Holancin Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060128000041 TN Practitioner - Physical Therapist in Private Practice 1951315910 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT7382TNMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Total Wellness LLC Orthopedic CurrentSince Mar 9, 2023 Accepting new patients
Back on Track, P.C. Orthopedic Past Accepting new patients
Back on Track, P.C. Orthopedic PastSince Dec 18, 2013 Accepting new patients

Locations

1647 Nashville Pike
Gallatin, TN 37066
Phone (615) 461-7833

210 Baber Park Pvt Dr W
Ste 160
Gallatin, TN 37066
Phone (615) 461-7833

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1164498382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CAPTAINS CIR",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370756732",
            "telephone_number": "615-859-0351",
            "fax_number": "615-859-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 GALLATIN PIKE N",
            "address_2": "SUITE 248",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152097",
            "telephone_number": "615-859-0351",
            "fax_number": "615-859-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "KRISTI",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "PT7382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3646335",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "HOLANCIN",
            "middle_name": "A",
            "prefix": "MS.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.