NPIMap

Organization Active NPI

Triangle Area Network Inc

  • Federally Qualified Health Center (FQHC)
  • Beaumont, TX
National Provider Identifier
1376584789
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRIANGLE AREA NETWORK INC
Practice address
1495 N 7TH St
Ste 5
Beaumont, TX 77702-1301
Phone
(409) 832-3377
Fax
(409) 832-3349
NPI assigned
Jun 8, 2006
Last updated
Sep 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Authorized official

Name
Ms. Amanda M Gibson
Title
Coo
Phone
(409) 832-8338

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X TX
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X TX

Addresses

Primary practice location

1495 N 7TH St
Ste 5
Beaumont, TX 77702-1301

Mailing address

1495 N 7TH St
Beaumont, TX 77702-1345
Phone (409) 832-8338

Other practice location 1

3727 N 16th St
Orange, TX 77632-4690
Phone (409) 920-4223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20060411000321 TX Part B Supplier - Clinic/Group Practice 3870502339 Receives reassigned benefits from 13 practitioners
Practice locations: Beaumont, TX; Orange, TX
O20170214000258 TX Part A Provider - Federally Qualified Health Center (FQHC) 3870502339 Practice locations: Orange, TX
O20180831000398 TX Part A Provider - Federally Qualified Health Center (FQHC) 3870502339 Practice locations: Beaumont, TX
O20230831001172 TX Part A Provider - Federally Qualified Health Center (FQHC) 3870502339 Practice locations: Beaumont, TX

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1376584789. Details of each certification follow.

Federally qualified health center certification: CCN 741944

Legal name
TRIANGLE AREA NETWORK INC
Doing business as
TRIANGLE AREA NETWORK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2017
Last certification
Feb 14, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 15, 1987 in TX
Enrollment address
3727 N 16TH St
Orange, TX 77632-4690

Federally qualified health center certification: CCN 451016

Legal name
TRIANGLE AREA NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 7, 2018
Last certification
Aug 7, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 15, 1987 in TX
Enrollment address
1495 N 7TH St
Beaumont, TX 77702-1345

Federally qualified health center certification: CCN 671099

Legal name
TRIANGLE AREA NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 22, 2023
Last certification
Jun 22, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 15, 1987 in TX
Enrollment address
2355 Interstate 10 E
Beaumont, TX 77702-1320

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2040836Triangle Area Network Inc1495 N 7TH Street, Suite 5, Beaumont, TX 77702Certificate of waiverMay 9, 2028
45D2128281Triangle Area Network3727 N 16TH St, Orange, TX 77632Certificate of waiverMar 27, 2027

National Provider Directory

National Provider Directory

Locations

1495 N 7th St
Beaumont, TX 77702
Phone (409) 832-3377

1495 N 7th St
Ste 5
Beaumont, TX 77702
Phone (409) 832-3377

2355 Interstate 10 E
Beaumont, TX 77702
Phone (409) 832-3377

3436 Fannin St
Bldg 2
Beaumont, TX 77701
Phone (409) 832-3373

3737 N 16th St
Orange, TX 77632
Phone (409) 920-4223

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGFEAD

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amanda Gibson Individual Corporate OfficerChief Operating Officer Mar 1, 2021 100%
Operational/Managerial Control Jun 1, 2019
Corporate Director Jun 1, 2016
Operational/Managerial Control Jun 1, 2016
Triangle Area Network Inc Organization, Orange, TX Corporation, Non-profit Operational/Managerial Control Jun 15, 1987 100%
Dena Hughes Individual Corporate OfficerChief Exectutive Officer Jun 1, 2016 100%
5% Or Greater Indirect Ownership InterestExecutive Director Jun 1, 2016 100%
Corporate DirectorExecutive Director Jun 1, 2016
W-2 Managing EmployeeExecutive Director Jun 1, 2016
Corporate OfficerChief Executive Officer Jun 1, 2016 100%
Corporate Director Jun 1, 2016
Sherry Ulmer Individual Corporate OfficerBoard of Directors President Feb 26, 2022
Jonathan J Dixxon Individual Corporate OfficerBoard of Directors Vice President Feb 26, 2022
Douglas C Salisbury Individual Corporate OfficerBoard of Directors Secretary Feb 26, 2022
Diane Cecile Bass Individual Corporate OfficerBoard of Directors Treasurer Feb 26, 2022

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1376584789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 N 7TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021345",
            "telephone_number": "409-832-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 N 7TH ST",
            "address_2": "STE 5",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021301",
            "telephone_number": "409-832-3377",
            "fax_number": "409-832-3349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3727 N 16th St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "TX",
            "postal_code": "776324690",
            "country_code": "US",
            "telephone_number": "409-920-4223",
            "fax_number": "409-920-4365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRIANGLE AREA NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "409-832-8338",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.