NPIMap

Organization Active NPI

Cardinal Health Services, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Winston Salem, NC
National Provider Identifier
1144575929
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
32185 Issued in NC
Legal business name
CARDINAL HEALTH SERVICES, PC
Practice address
3069 Trenwest Dr
Ste 200
Winston Salem, NC 27103-3211
Phone
(336) 448-0962
Fax
(336) 992-3930
NPI assigned
Jul 18, 2012
Last updated
Dec 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Mr. Henry Franklin Tripp Jr., M.D.
Title
Director
Phone
(336) 993-3146

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 32185 NC
Geriatric Medicine (Family Medicine) Physician 207QG0300X 32185 NC Primary

Addresses

Primary practice location

3069 Trenwest Dr
Ste 200
Winston Salem, NC 27103-3211

Mailing address

PO Box 30575
Winston Salem, NC 27130-0575
Phone (336) 448-0962

Other identifiers 1

IdentifierTypeStateIssuer
34D2049903OtherNCCLIA #

National Provider Directory

National Provider Directory

Locations

3069 Trenwest Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 448-0962

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1144575929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30575",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271300575",
            "telephone_number": "336-448-0962",
            "fax_number": "336-992-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3069 TRENWEST DR",
            "address_2": "STE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033211",
            "telephone_number": "336-448-0962",
            "fax_number": "336-992-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL HEALTH SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-993-3146",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "32185",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "32185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "34D2049903",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.