Tristan Daniel Phillips

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-05377 Issued in OH

Practice address

807 30TH St NE
Canton, OH 44714-1404

Phone

(330) 491-0381

NPI assigned

Jan 23, 2018

Last updated

Jul 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

McBrearty Family and Sport Chiropractic,LLCGroup PAC ID 5496857773, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McBrearty Family & Sport Chiropractic,LLC

  • Sports Physician Chiropractor
  • Canton, OH
  • NPI 1437218492
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1629576863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 30TH ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447141404",
            "telephone_number": "330-491-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 30TH ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447141404",
            "telephone_number": "330-491-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TRISTAN",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-05377",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Phillips
• Charde Phillips
• Danita J Phillips
• Samyha Phillips
• Shane M Phillips, PHARMD, RPH
• Phoenix Dermatology LTD
• Phoenix Rising Behavioral Healthcare and Recovery Inc (Phoenix Rising BHR)
• Phoenix Rising Behavioral Healthcare and Recovery, Inc
• Phoenix Rising Behavioral Healthcare and Recovery, Inc
• Kiran Phuloria, DO

• Chiropractor in Canton, OH
• Providers in Canton, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.