Tristar Physical Therapy and Chiropractic

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

11101 Issued in TN

Legal business name

TRISTAR PHYSICAL THERAPY AND CHIROPRACTIC

Practice address

2024 E Andrew Johnson Hwy
Morristown, TN 37814-5410

Phone

(423) 317-7772

Fax

(423) 317-7773

NPI assigned

Jul 17, 2018

Organization subpart

No

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

Authorized official

Name

Jordan Black

Title

PT, DPT, Owner

Phone

(423) 258-2264

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1437635034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 E ANDREW JOHNSON HWY",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378145410",
            "telephone_number": "423-317-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 E ANDREW JOHNSON HWY",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378145410",
            "telephone_number": "423-317-7772",
            "fax_number": "423-317-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR PHYSICAL THERAPY AND CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PT, DPT, OWNER",
        "authorized_official_telephone_number": "423-258-2264"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TN",
            "license": "11101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q027222",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Michelle Trent
• Matthew Trent
• Mattie Lee Trent, FNP
• Michael Ray Trent, PHARM D
• Kayla Leeann Trezona
• Tristar Physical Therapy LLC
• True Life Wellness
• Madison Truman, PA-C
• Amanda Lynn Tucker, RDH, BS
• Anthony Carl Tullock

• Physical Therapy Clinic/Center in Morristown, TN
• Providers in Morristown, TN by specialty
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; 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.