Tiarks Therapy Services

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT3288 Issued in AR

Legal business name

TIARKS THERAPY SERVICES

Practice address

2104 S Walton Blvd
Bentonville, AR 72712-6732

Phone

(479) 619-5514

NPI assigned

Dec 19, 2017

Organization subpart

No

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

Authorized official

Name

Tristan N Tiarks, DPT

Title

Physical Therapist, Owner

Phone

(479) 619-5514

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1851807424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 N LEXINGTON DR",
            "city": "CENTERTON",
            "state": "AR",
            "postal_code": "727199539",
            "telephone_number": "479-619-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 S WALTON BLVD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126732",
            "telephone_number": "479-619-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIARKS THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "TIARKS",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "479-619-5514",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AR",
            "license": "PT3288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183881721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Physical Medicine & Rehabilitation Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.