Tristar Therapy Group FL LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TRISTAR THERAPY GROUP FL LLC

Practice address

2100 A1A S Suite 2
St. Augustine, FL 32080

Phone

(904) 419-9429

Fax

(423) 373-1351

NPI assigned

Aug 25, 2021

Organization subpart

No

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

Authorized official

Name

Jordan Black, PT, DPTNPI 1548718760

Title

Owner

Phone

(904) 419-9429

Specialties & licenses 1

Addresses

Tax ID family

Tristar Physical Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tristar Physical Therapy LLC

  • Physical Therapist
  • Morristown, TN
  • NPI 1770116485
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan Chase Black, DPT

  • Physical Therapist
  • Morristown, TN
  • NPI 1548718760
  NPD Authorized official

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1346917663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N 6TH ST # 788",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320841920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 A1A S SUITE 2",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32080",
            "telephone_number": "904-419-9429",
            "fax_number": "423-373-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR THERAPY GROUP FL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-419-9429",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri County Eye Associates PA
• Triforce Fitness, LLC
• Gaurav Trikha, MD
• Trinity Health South PLLC
• Trinity Relationship Center, LLC
• Nicole Chingoon Tristram, PT
• McKenzie Trombley
• Meaghan Truglio, LCSW
• Gary Charles Trupo, D.C.
• Ryan Tsai

• Physical Therapist in St. Augustine, FL
• Providers in St. Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.