Nicole Chingoon Tristram, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 17260 Issued in FL

Practice address

4057 Seminole Point CT
St Augustine, FL 32086-5851

Phone

(904) 315-0667

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Premiere Pilates Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Premiere Pilates Rehabilitation and Fitness

  • Physical Therapist
  • St Augustine, FL
  • NPI 1528373073
  NPD Authorized official
• Body Works Studio Inc

  • Physical Therapy Clinic/Center
  • Neptune Beach, FL
  • NPI 1659564920

  Physical Therapist

  NPD (past)
• Bodywise Studios, Inc.

  • Physical Therapy Clinic/Center
  • St Augustine, FL
  • NPI 1023106127
  NPD (past)
• First Coast Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • St Augustine, FL
  • NPI 1003823709

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1508956996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4057 SEMINOLE POINT CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865851",
            "telephone_number": "904-797-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 SEMINOLE POINT CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865851",
            "telephone_number": "904-315-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRISTRAM",
        "first_name": "NICOLE",
        "middle_name": "CHINGOON",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 17260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887725400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PREMIERE",
            "last_name": "PILATES",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Triforce Fitness, LLC (Power Up Performance Therapy)
• Gaurav Trikha, MD
• Trinity Health South PLLC
• Trinity Relationship Center, LLC
• Tristar Therapy Group FL LLC
• McKenzie Trombley
• Meaghan Truglio, LCSW
• Gary Charles Trupo, D.C.
• Ryan Tsai
• Ping Yan Lilian Tsui, MSN/FNP-C

• 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 Nov 17, 2009; 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.