Tristar Injury Center of Riverdale LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TRISTAR INJURY CENTER OF RIVERDALE LLC

Practice address

34 Upper Riverdale Rd SE Ste 206
Riverdale, GA 30274-2635

Phone

(404) 479-1455

Fax

(407) 539-8557

NPI assigned

Mar 20, 2023

Organization subpart

No

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

Authorized official

Name

Alex Jutis, DC

Title

Ceo

Phone

(678) 730-6240

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1932801438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 LAWRENCEVILLE SUWANEE RD STE C",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246503",
            "telephone_number": "678-730-6240",
            "fax_number": "678-730-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 UPPER RIVERDALE RD SE STE 206",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742635",
            "telephone_number": "404-479-1455",
            "fax_number": "407-539-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR INJURY CENTER OF RIVERDALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "JUTIS",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-730-6240",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.