NPI |
1164834057 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Entity Type Code |
2 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Employer Identification Number EIN |
|
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider Organization Name Legal Business Name |
TRISTAR JOINT REPLACEMENT INSTITUTE, LLC |
The first name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
2400 PATTERSON ST |
The middle name of the provider, if the provider
is an individual. |
Provider Second Line Business Practice Location Address |
SUITE 100 |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider Business Practice Location Address City Name |
NASHVILLE |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address State Name |
TN |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
372031562 |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Telephone Number |
6153420038 |
The country code in the location address of the provider being identified. |
Provider Enumeration Date |
5/27/2014 |
The telephone number associated with the location address of the provider being identified. |
Last Update Date |
10/8/2014 |
The fax number associated with the location
address of the provider being identified. |
Authorized Official Last Name |
DUNCAN |
The date the provider was assigned a unique identifier (assigned an NPI). |
Authorized Official First Name |
GARY |
The date that a record was last updated or changed. |
Authorized Official Title or Position |
VP |
The code designating the provider’s gender if the provider is a person. |
Authorized Official Telephone Number |
6158864969 |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Taxonomy Code 1 |
207X00000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Organization Subpart |
N |
|
Healthcare Provider Taxonomy Group 1 |
193400000X SINGLE SPECIALTY GROUP |
|