Trinity Pediatric Medicine of College Park, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

TRINITY PEDIATRIC MEDICINE OF COLLEGE PARK, LLC

Practice address

6524 Old National Hwy
BLDG. B, Ste 102
Atlanta, GA 30349

Phone

(678) 472-3734

NPI assigned

Aug 16, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Carina Gibbs

Title

Cfo

Phone

(678) 472-3734

Specialties & licenses 1

Addresses

Other identifiers 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

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1396410882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6524 OLD NATIONAL HWY",
            "address_2": "BLDG. B, STE 102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30349",
            "telephone_number": "678-472-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6524 OLD NATIONAL HWY",
            "address_2": "BLDG. B, STE 102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30349",
            "telephone_number": "678-472-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY PEDIATRIC MEDICINE OF COLLEGE PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "CARINA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-472-3734",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRIC MEDICINE",
            "identifier": "1407950876",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jyles a. Trinidad, PHARMD, RPH
• Kimberly Christine Trinidad, PHARM.D
• Trinity Behavioral and Medical Solutions
• Trinity Hospice of Georgia, LLC
• Trinity Medical Solutions, LLC
• Trinity Pediatric Medicine of Fayetteville
• Trinity Pharmacy Enterprise II LLC
• Trinity Pharmacy Enterprise, LLC
• Marvin Trinkaus II, ATC
• Priti Tripathi

• Pediatrics Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.