NPIMap

Organization Active NPI

Triumph LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
National Provider Identifier
1316200090
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TRIUMPH LLC
Practice address
5505 Creedmoor Rd
Ste. 100
Raleigh, NC 27612-6352
Phone
(919) 852-5352
Fax
(919) 852-5323
NPI assigned
Jun 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Authorized official

Name
Gerald Enevoldsen Jr.
Title
Program Director
Phone
(919) 771-4854

Specialties & licenses 1

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

Addresses

Primary practice location

5505 Creedmoor Rd
Ste. 100
Raleigh, NC 27612-6352

Mailing address

5505 Creedmoor Rd
Ste. 100
Raleigh, NC 27612-6352

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1316200090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 CREEDMOOR RD",
            "address_2": "STE. 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 CREEDMOOR RD",
            "address_2": "STE. 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126352",
            "telephone_number": "919-852-5352",
            "fax_number": "919-852-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUMPH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "ENEVOLDSEN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "919-771-4854",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.