NPIMap

Organization Active NPI

Triad Breast Imaging Center, LLC

Doing business as Novant Health Breast Imaging Center Greensboro

  • Diagnostic Radiology Physician
  • Greensboro, NC
National Provider Identifier
1245859453
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TRIAD BREAST IMAGING CENTER, LLC
Doing business as
Novant Health Breast Imaging Center Greensboro
Practice address
3515 W Market St Ste 320
Greensboro, NC 27403-4442
Phone
(336) 660-5420
Fax
(336) 660-5429
NPI assigned
Apr 9, 2020
Last updated
Mar 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Mr. Geoffrey K. Gardner
Title
SVP Finance and Revenue Cycle
Phone
(678) 992-7255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3515 W Market St Ste 320
Greensboro, NC 27403-4442

Mailing address

3480 Preston Ridge Rd Ste 600
Alpharetta, GA 30005-5462
Phone (770) 300-0101

Other names 1

  • Novant Health Breast Imaging Center Greensboro Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201216002466 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2961814991 Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1245859453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 PRESTON RIDGE RD STE 600",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300055462",
            "telephone_number": "770-300-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 W MARKET ST STE 320",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274034442",
            "telephone_number": "336-660-5420",
            "fax_number": "336-660-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD BREAST IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "SVP FINANCE AND REVENUE CYCLE",
        "authorized_official_telephone_number": "678-992-7255",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Breast Imaging Center Greensboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.

Verify at the official NPI Registry.