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TRINITY FAMILY AND SPORTS MEDICINE PA
NPI 1891991238
Family Medicine - Sports Medicine in Trinity, FL

Active since June 22, 2007CLIA 10D1074473 · Waiver
1807 SHORT BRANCH DR, #102, TRINITY, FL 34655(727) 376-3547(866) 439-9035 Get Directions Write a Review

NPPES record last updated: July 12, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Trinity Family And Sports Medicine Pa NPPES

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

TRINITY FAMILY AND SPORTS MEDICINE PA (NPI 1891991238) is a healthcare organization registered as a sports medicine in Trinity, Florida and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through September 27, 2027 and lists Jesse D Tippett, Owner, as its authorized official.

NPPES Registry Identity

NPI1891991238
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameTRINITY FAMILY AND SPORTS MEDICINE PA
Location Address1807 SHORT BRANCH DR, #102Trinity, FL 34655-4415
Mailing Address1807 Short Branch Drive, #102Trinity, FL 34655 · (727) 376-3547 · Fax (866) 439-9035
Phone(727) 376-3547
Fax(866) 439-9035
Organization SubpartNo
Authorized OfficialJesse D TippettOwner · (727) 376-3547
Enumeration DateJune 22, 2007
Last NPPES UpdateJuly 12, 2016
✔ NPI 1891991238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in FL · ME93868
Definition
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.
1807 SHORT BRANCH DR, Trinity, FL 34655
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Other Identifiers 2

Medicare UPINI43083FL
Medicaid279176500FL

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Trinity Family And Sports Medicine Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20080404000336Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Trinity Family And Sports Medicine PA, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Jesse Tippett, M.D.
Family Practice
NPI 1083717862
1807 SHORT BRANCH DR SUITE 102
Trinity, FL 34655
(727) 376-3547
✔ PECOS✔ Accepts MedicareSame address
Juliane Chavez
Nurse Practitioner
NPI 1275018749
1807 SHORT BRANCH DR STE 102
Trinity, FL 34655
(727) 376-3547
✔ PECOSSame address
Mary Goodman, NURSE PRACTITIONER
Nurse Practitioner
NPI 1265105803
1807 SHORT BRANCH DR STE 102
New Port Richey, FL 34655
(727) 376-3547
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1074473

Trinity Family And Sports Medicine PA · Trinity, FL
Active · expires Sep 27, 2027
CLIA Number10D1074473
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2025
Certificate Expiration DateSeptember 27, 2027
Laboratory DirectorJesse Tippett
Laboratory Phone(727) 376-3457
Laboratory LocationTrinity Family And Sports Medicine PA1807 Short Branch Dr Ste 102, Trinity, FL 34655
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Trinity Family And Sports Medicine PA's NPI number?

The NPI number for Trinity Family And Sports Medicine PA is 1891991238. It was assigned to this organization in the NPPES registry on June 22, 2007.

Where is Trinity Family And Sports Medicine PA located?

Trinity Family And Sports Medicine PA is located at 1807 Short Branch Dr #102, Trinity, FL 34655. The listed phone number is (727) 376-3547.

What is Trinity Family And Sports Medicine PA's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Trinity Family And Sports Medicine PA enrolled in Medicare?

Yes. Trinity Family And Sports Medicine PA is registered in the Medicare PECOS enrollment system.

When is Trinity Family And Sports Medicine PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Trinity Family And Sports Medicine PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Trinity Family And Sports Medicine PA, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Trinity Family And Sports Medicine PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1074473) is associated with this NPI, valid through September 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Trinity Family And Sports Medicine PA accept?

Health plans from AvMed list Trinity Family And Sports Medicine PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Trinity Family And Sports Medicine PA was last updated on July 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.