Tryst Private Homecare Inc

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

075-R-0884 Issued in GA

Legal business name

TRYST PRIVATE HOMECARE INC

Practice address

331 Black Willow CT
Locust Grove, GA 30248-6606

Phone

(770) 598-7558

Fax

(678) 432-5075

NPI assigned

Jul 8, 2013

Last updated

Jul 8, 2013By 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

Modupe Oluyemisi Salami, FNPNPI 1619273133

Title

Ceo

Phone

(770) 598-7558

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Modupe Oluyemisi Salami, FNP

  • Family Nurse Practitioner
  • Locust Grove, GA
  • NPI 1619273133
  Authorized official Same address or phone

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1932540903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 BLACK WILLOW CT",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302486606",
            "telephone_number": "770-598-7558",
            "fax_number": "678-432-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 BLACK WILLOW CT",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302486606",
            "telephone_number": "770-598-7558",
            "fax_number": "678-432-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRYST PRIVATE HOMECARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "SALAMI",
        "authorized_official_first_name": "MODUPE",
        "authorized_official_middle_name": "OLUYEMISI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-598-7558",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "075-R-0884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Faye Tison, APRN, FNP-C
• Shareka Toney
• Total Renal Care Inc (Locust Grove Dialysis)
• Nimisha J Trivedi, MD
• Bria Janae Truesdale, LMT, LE
• Elizabeth Catherine Tully, DC
• Peter James Tully, D.C.
• George Turman, CRNA
• Velocity Health Partners LLC
• Villon Family Hospice

• Nursing Care Agency in Locust Grove, GA
• Providers in Locust Grove, GA by specialty
• Nursing Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.