Active NPI
Kristi H Roland, DPT
- Orthopedic Physical Therapist
- Madison, TN
National Provider Identifier
1164498382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT7382
- 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, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3646335 | Medicaid | TN |
Other names 1
- Ms. Kristi A Holancin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT7382 | TN | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elevate Total Wellness LLC | Orthopedic | Current | Accepting new patients |
| Back on Track, P.C. | Orthopedic | Past | Accepting new patients |
| Back on Track, P.C. | Orthopedic | Past | 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.
-
dba The Movement Shop
- Physical Therapist
- Gallatin, TN
- NPI 1053041996
Orthopedic
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.