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TRISTAR SPINE AND SPORT CHIROPRACTIC LLC
NPI 1629827159
Chiropractor in Bristol, TN

Active since May 16, 2024
126 MLK JR BLVD STE A, BRISTOL, TN 37620(423) 764-2663(423) 793-1100 Get Directions Write a Review

NPPES record last updated: September 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 18, 2025, May 16, 2024 (2 updates tracked since 2024).

About Tristar Spine And Sport Chiropractic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRISTAR SPINE AND SPORT CHIROPRACTIC LLC (NPI 1629827159) is a healthcare organization registered as a chiropractor in Bristol, Tennessee and active in the NPI registry since May 2024. The organization lists Thaddeus Keklak, Owner, Chiropractor, as its authorized official.

NPPES Registry Identity

NPI1629827159
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameTRISTAR SPINE AND SPORT CHIROPRACTIC LLC
Location Address126 MLK JR BLVD STE ABristol, TN 37620-4078
Mailing Address126 Mlk Jr Blvd Ste ABristol, TN 37620-4078 · (423) 764-2663 · Fax (423) 793-1100
Phone(423) 764-2663
Fax(423) 793-1100
Organization SubpartNo
Authorized OfficialThaddeus KeklakOwner, Chiropractor · (423) 360-7366
Enumeration DateMay 16, 2024
Last NPPES UpdateSeptember 18, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2025
✔ NPI 1629827159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

126 MLK JR BLVD STE A, Bristol, TN 37620
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tristar Spine And Sport Chiropractic LLC's NPI number?

The NPI number for Tristar Spine And Sport Chiropractic LLC is 1629827159. It was assigned to this organization in the NPPES registry on May 16, 2024.

Where is Tristar Spine And Sport Chiropractic LLC located?

Tristar Spine And Sport Chiropractic LLC is located at 126 Mlk Jr Blvd Ste A, Bristol, TN 37620. The listed phone number is (423) 764-2663.

What is Tristar Spine And Sport Chiropractic LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Tristar Spine And Sport Chiropractic LLC was last updated on September 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.