Tristan Anderson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

7598 Issued in MS

Practice address

423B Memorial Blvd
Picayune, MS 39466-5545

Phone

(769) 242-2772

Fax

(769) 242-0513

NPI assigned

Dec 4, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Schneider Therapy Clinic LLC

  • Physical Therapy Clinic/Center
  • Picayune, MS
  • NPI 1114535820
  NPD

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1285440487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423B MEMORIAL BLVD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665545",
            "telephone_number": "769-242-2772",
            "fax_number": "769-242-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423B MEMORIAL BLVD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665545",
            "telephone_number": "769-242-2772",
            "fax_number": "769-242-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TRISTAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "7598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Brian Allen, DPT
• Miranda Lynn Alphonso, PHARMD
• Calie Marie Alsobrooks
• Amedisys Mississippi, LLC
• Joseph Anderson, PMHNP-BC
• Juanita Antoine
• George Arthur Applewhite, M.D.
• April Lynn Arnona, NP
• Chris Arthur
• Halie Dyess Barnes, PHARM D

• All providers in Picayune, MS
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.