Active NPI
Triad Health Systems Inc.
- Federally Qualified Health Center (FQHC)
- Carrollton, KY
National Provider Identifier
1104248962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- TRIAD HEALTH SYSTEMS INC.
- Practice address
- 329 Floyd Dr
Carrollton, KY 41008-8261 - Phone
- (502) 732-1082
- Fax
- (859) 567-1253
- NPI assigned
- Jan 14, 2014
- Organization subpart
- Yes
- Parent organization
- TRIAD HEALTH SYSTEMS INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jessica Wheeler
- Title
- General Manager
- Phone
- (859) 567-1271
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | KY | Primary | |
| Primary Care Clinic/Center | 261QP2300X | KY | ||
| Family Nurse Practitioner | 363LF0000X | KY |
Addresses
Primary practice location
329 Floyd Dr
Carrollton, KY 41008-8261
Mailing address
PO Box 845
Warsaw, KY 41095-0845
Phone (859) 567-1591
Other names 1
- Triad Health Systems Carrollton Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- Warsaw, KY
- NPI 1831311299
O20100806000077
National Provider Directory
National Provider Directory- Part of
- Triad Health Systems Inc
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Federally Qualified Health Center (FQHC)
- Warsaw, KY
- NPI 1831311299
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Florence, KY
- NPI 1811852205
Federally Qualified Health Center (FQHC)
-
- Clinical Social Worker
- Lexington, KY
- NPI 1316902232
-
- Neurology Physician
- Covington, KY
- NPI 1518921329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1541548800000",
"number": "1104248962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 845",
"city": "WARSAW",
"state": "KY",
"postal_code": "410950845",
"telephone_number": "859-567-1591",
"fax_number": "859-567-1253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 FLOYD DR",
"city": "CARROLLTON",
"state": "KY",
"postal_code": "410088261",
"telephone_number": "502-732-1082",
"fax_number": "859-567-1253"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRIAD HEALTH SYSTEMS INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRIAD HEALTH SYSTEMS INC.",
"enumeration_date": "2014-01-14",
"last_updated": "2018-11-07",
"status": "A",
"authorized_official_last_name": "WHEELER",
"authorized_official_first_name": "JESSICA",
"authorized_official_title_or_position": "GENERAL MANAGER",
"authorized_official_telephone_number": "859-567-1271"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "KY",
"license": null,
"primary": true
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "KY",
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Triad Health Systems Carrollton Clinic",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Triad Health Systems Carrollton Clinic",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Carrollton, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.