NPIMap

Organization Active NPI

Piedmont Triad Regional Council

  • Community/Behavioral Health Agency
  • Yanceyville, NC
National Provider Identifier
1124514633
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PIEDMONT TRIAD REGIONAL COUNCIL
Practice address
649 Firetower Road
Yanceyville, NC 27379
Phone
(336) 694-7447
NPI assigned
Jul 9, 2018
Organization subpart
Yes
Parent organization
PIEDMONT TRIAD REGIONAL COUNCILAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Authorized official

Name
Matthew Dolge
Title
Executive Director
Phone
(336) 904-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

649 Firetower Road
Yanceyville, NC 27379

Mailing address

1398 Carrollton Crossing Dr
Kernersville, NC 27284-3896
Phone (336) 904-0300

Other practice location 1

1398 Carrollton Crossing Dr
Kernersville, NC 27284-3896
Phone (336) 904-0300

Other practice location 2

102 N Washington Ave
Reidsville, NC 27320-3446
Phone (336) 349-1088

Other practice location 3

629 Industrial Park Ave
Asheboro, NC 27205-7333
Phone (336) 904-0300

Other names 1

  • Piedmont Triad Regional Council Diabetes Education Program Other name

National Provider Directory

National Provider Directory
Part of
Piedmont Triad RGNL Council

Locations

102 N Washington Ave
Reidsville, NC 27320
Phone (336) 349-1088

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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531094400000",
    "number": "1124514633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 CARROLLTON CROSSING DR",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843896",
            "telephone_number": "336-904-0300",
            "fax_number": "336-904-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 FIRETOWER ROAD",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "27379",
            "telephone_number": "336-694-7447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1398 Carrollton Crossing Dr",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272843896",
            "country_code": "US",
            "telephone_number": "336-904-0300",
            "fax_number": "336-904-0361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Reidsville",
            "state": "NC",
            "postal_code": "273203446",
            "country_code": "US",
            "telephone_number": "336-349-1088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "629 Industrial Park Ave",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272057333",
            "country_code": "US",
            "telephone_number": "336-904-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PIEDMONT TRIAD REGIONAL COUNCIL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIEDMONT TRIAD REGIONAL COUNCIL",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-07-09",
        "status": "A",
        "authorized_official_last_name": "DOLGE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-904-0300"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Triad Regional Council Diabetes Education Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Piedmont Triad Regional Council Diabetes Education Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yanceyville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.