Trisource, LLC

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

Legal business name

TRISOURCE, LLC

Practice address

7467 Ridge Rd Ste 120
Hanover, MD 21076-3184

Phone

(410) 782-0641

Fax

(410) 782-0641

NPI assigned

Jun 9, 2025

Last updated

Jun 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Eckenrode

Title

President

Phone

(410) 782-0641

Specialties & licenses 1

Addresses

Other names 1

• Fleck Holdings LLC Former legal business name

Locations

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1245124650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7467 RIDGE RD STE 120",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763184",
            "telephone_number": "410-782-0641",
            "fax_number": "410-782-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7467 RIDGE RD STE 120",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763184",
            "telephone_number": "410-782-0641",
            "fax_number": "410-782-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISOURCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "ECKENRODE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-782-0641"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fleck Holdings LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Julie Tran, O.D.
• Vivian Tran, PHARMD
• Nanette Julie Trent, RN
• Tress RX
• Kelly Ann Tressler, PHARMD
• Michelle A Tucker-Jones, FNP-BC, PMHNP-BC
• Roxanne Talbott Turner
• Ntaobasi Patrick Udeh, AGACNP-BC
• Light Ayokunle Umukoro
• University of Maryland Community Medical Group, Inc.

• Medical-Surgical Registered Nurse in Hanover, MD
• Providers in Hanover, MD by specialty
• Medical-Surgical Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.