Trinity Family and Sports Medicine PA

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

ME93868 Issued in FL

Legal business name

TRINITY FAMILY AND SPORTS MEDICINE PA

Practice address

1807 Short Branch Dr
#102
Trinity, FL 34655-4415

Phone

(727) 376-3547

Fax

(866) 439-9035

NPI assigned

Jun 22, 2007

Last updated

Jul 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jesse D Tippett, MDNPI 1083717862

Title

Owner

Phone

(727) 376-3547

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jesse Tippett, M.D.

  • Family Medicine Physician
  • Trinity, FL
  • NPI 1083717862
  Medicare reassignment NPD Authorized official
• Juliane Chavez

  • Adult Health Nurse Practitioner
  • Trinity, FL
  • NPI 1275018749
  Medicare reassignment NPD
• Mary Lisa Goodman, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • New Port Richey, FL
  • NPI 1265105803
  Medicare reassignment NPD
• Lolita Shapiro, ARNP

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1740914464
  NPD (past)
• Juliay Tippett, LCSW

  • Clinical Social Worker
  • Tampa, FL
  • NPI 1972546349
  NPD (past)

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1891991238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 SHORT BRANCH DRIVE",
            "address_2": "#102",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "34655",
            "telephone_number": "727-376-3547",
            "fax_number": "866-439-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 SHORT BRANCH DR",
            "address_2": "#102",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554415",
            "telephone_number": "727-376-3547",
            "fax_number": "866-439-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY FAMILY AND SPORTS MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "TIPPETT",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-376-3547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME93868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279176500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sandra Triglia, MS.ED., BCBA
• Trinity Counseling Center Inc (1540 Counseling)
• Trinity Dental Arts PLLC
• Trinity Family Eyecare, P.a.
• Trinity Family Physicians PL
• Trinity Foot and Ankle PLLC
• Trinity Hearing &Balance Center
• Trinity Medical Associates L L C

• Sports Medicine (Family Medicine) Physician in Trinity, FL
• Providers in Trinity, FL by specialty
• Sports Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.