Triad Interventional Pain Center, PA

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

2005-00043 Issued in NC

Legal business name

TRIAD INTERVENTIONAL PAIN CENTER, PA

Practice address

900 Old Winston Rd
Suite 112
Kernersville, NC 27284-9964

Phone

(704) 645-7196

Fax

(704) 658-0418

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Tarsha V Garvin, M.D.NPI 1649248444

Title

President/Physician

Phone

(704) 645-7196

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Tarsha V. Garvin, MD

  • Interventional Pain Medicine Physician
  • Kernersville, NC
  • NPI 1649248444
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1306013628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 OLD WINSTON RD",
            "address_2": "SUITE 112",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849964",
            "telephone_number": "704-645-7196",
            "fax_number": "704-658-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 OLD WINSTON RD",
            "address_2": "SUITE 112",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849964",
            "telephone_number": "704-645-7196",
            "fax_number": "704-658-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD INTERVENTIONAL PAIN CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "GARVIN",
        "authorized_official_first_name": "TARSHA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "704-645-7196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NC",
            "license": "2005-00043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950096",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "1380R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connor Treyball
• Tri-City Speech-Language Pathology Services, PLLC
• Tri-Support Services (CM Services)
• Triad Family Chiropractic, PLLC
• Triad Health Solutions
• Triad Outreach LLC
• Kierra Troublefield
• Taylor Marie Trowbridge
• Shelly Lenay Truhe, STUDENT
• Dana M. Truman-Schram, MA, LPA

• Interventional Pain Medicine Physician in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Interventional Pain Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.