Active NPI
Triumph, LLC
- Psychiatry Physician
- North Wilkesboro, NC
National Provider Identifier
1043314792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- TRIUMPH, LLC
- Practice address
- 118 Peace St
North Wilkesboro, NC 28659-4519 - Phone
- (336) 667-1440
- NPI assigned
- Sep 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Caldwell
- Title
- Ceo
- Phone
- (919) 467-2433
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
118 Peace St
North Wilkesboro, NC 28659-4519
Mailing address
2101 Gateway Centre Blvd
Suite 100
Morrisville, NC 27560-6214
Phone (919) 467-2433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6005574 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Triumph LLC
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1043314792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 GATEWAY CENTRE BLVD",
"address_2": "SUITE 100",
"city": "MORRISVILLE",
"state": "NC",
"postal_code": "275606214",
"telephone_number": "919-467-2433",
"fax_number": "919-467-4903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 PEACE ST",
"city": "NORTH WILKESBORO",
"state": "NC",
"postal_code": "286594519",
"telephone_number": "336-667-1440"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRIUMPH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CALDWELL",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "919-467-2433"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6005574",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Wilkesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.