Organization Active NPI

Tristar Injury Center of Midtown

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1932882578
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TRISTAR INJURY CENTER OF MIDTOWN
Practice address
147 North Ave NE
Atlanta, GA 30308-2328
Phone
(678) 730-6240
NPI assigned
Aug 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

147 North Ave NE
Atlanta, GA 30308-2328

Mailing address

3441 Lawrenceville Suwanee Rd Ste C
Suwanee, GA 30024-6503
Phone (678) 730-6240

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1932882578",
    "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": "147 NORTH AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082328",
            "telephone_number": "678-730-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR INJURY CENTER OF MIDTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "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": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.