Tri State Community Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TRI STATE COMMUNITY CLINIC, LLC

Practice address

1033 E Mt. Pleasant Rd., Ste. D.
Evansville, IN 47725

Phone

(888) 492-8722

Fax

(812) 491-0333

NPI assigned

May 23, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ronald Chad Perkins, MD

Title

Cmo

Phone

(888) 492-8722

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1104317346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 E MT. PLEASANT RD., STE. D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47725",
            "telephone_number": "888-492-8722",
            "fax_number": "812-491-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 E MT. PLEASANT RD., STE. D.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47725",
            "telephone_number": "888-492-8722",
            "fax_number": "812-491-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE COMMUNITY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "888-492-8722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly N Traylor, FNP
• Olivia Treski
• Jayme A Trevino, MSW LCSW
• Karen Trevino, M.D.
• Meghan Elizabeth Trevino, LCSW
• Tri State Immunization Group Inc
• Tri State Internal Medicine Source
• Tri State RX, LLC
• Tri State Transportation
• Tri-State Anesthesiologists, PC

• Family Medicine Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.