| Tristar Family Care | |
|
126 W Paris St Huntingdon TN 38344-3608 | |
| (731) 535-3600 | |
| (731) 535-3603 |
| Full Name | Tristar Family Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 126 W Paris St, Huntingdon, Tennessee |
| Authorized Official Name and Position | Lisa Kay Page (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7316933465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tristar Family Care Po Box 506 Huntingdon TN 38344-0506 Ph: (731) 431-2579 | Tristar Family Care 126 W Paris St Huntingdon TN 38344-3608 Ph: (731) 535-3600 |
| NPI Number | 1104571405 |
|---|---|
| Provider Enumeration Date | 02/15/2022 |
| Last Update Date | 09/21/2026 |
| Certification Date | 09/21/2026 |
| Medicare PECOS PAC ID | 9537556378 |
|---|---|
| Medicare Enrollment ID | O20220427000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104571405 | NPI | - | NPPES |
| Q071950 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
| Provider Name | Heather Anne Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750390399 PECOS PAC ID: 1759336100 Enrollment ID: I20050317001035 |
| Provider Name | Angela Renae Tippitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588083133 PECOS PAC ID: 8325362874 Enrollment ID: I20150112000574 |
| Provider Name | Keliea Ann Winstead |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003353699 PECOS PAC ID: 2163789462 Enrollment ID: I20171121002354 |
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