TRINITY FAMILY AND SPORTS MEDICINE PA NPI 1891991238

NPI Information

  • NPI: 1891991238
  • Provider Name: TRINITY FAMILY AND SPORTS MEDICINE PA
  • Classification: Family Medicine - 207QS0010X
  • Specialization: Sports Medicine
  • Entity Type: Organization
  • CLIA Number: 10D1074473
  • Address: 1807 SHORT BRANCH DR
    #102
    TRINITY, FL
    ZIP 34655
  • Phone: (727) 376-3547

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NPI Details

TRINITY FAMILY AND SPORTS MEDICINE PA is a sports medicine family medicine in Trinity, FL. The provider is a family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. TRINITY FAMILY AND SPORTS MEDICINE PA NPI is 1891991238. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1807 SHORT BRANCH DR
#102
TRINITY, FL
ZIP 34655-415
Phone: (727) 376-3547
Fax: (866) 439-9035

The provider's authorized official is Jesse D Tippett .
The authorized official title is Owner and has the following contact phone number (727) 376-3547.

The CLIA number assigned to this NPI record is 10D1074473 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2007 and was last updated on 7/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QS0010XFamily MedicineSports MedicineME93868FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1I43083MEDICARE UPINFLORIDA
2279176500MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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