Trinity Spine and Orthopedics, PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

TRINITY SPINE AND ORTHOPEDICS, PLLC

Practice address

4444 Heritage Trace
Suite 408
Keller, TX 76244

Phone

(817) 283-5252

Fax

(817) 283-5283

NPI assigned

Jun 16, 2020

Organization subpart

No

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

Authorized official

Name

Larry M Kjeldgaard, DO

Title

Owner / President

Phone

(817) 283-5252

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1477178374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 HERITAGE TRACE",
            "address_2": "SUITE 408",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-283-5252",
            "fax_number": "817-283-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 HERITAGE TRACE",
            "address_2": "SUITE 408",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-283-5252",
            "fax_number": "817-283-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY SPINE AND ORTHOPEDICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "KJELDGAARD",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "817-283-5252",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "H3398",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Corey Tucker, PTA
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• Orthopaedic Surgery Physician in Keller, TX
• Providers in Keller, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.