NPIMap

Organization Active NPI

Triad Pediatrics, PC

  • Pediatrics Physician
  • High Point, NC
National Provider Identifier
1407355704
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2007-00476 Issued in NC
Legal business name
TRIAD PEDIATRICS, PC
Practice address
4012 Mendenhall Oaks Pkwy
High Point, NC 27265-8076
Phone
(336) 822-9671
Fax
(336) 882-2824
NPI assigned
Feb 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Authorized official

Name
Dr. Thomas Wayne Dillard, MDNPI 1083833826
Title
Owner
Phone
(336) 822-9671

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 2007-00476 NC Primary

Addresses

Primary practice location

4012 Mendenhall Oaks Pkwy
High Point, NC 27265-8076

Mailing address

4148 Mendenhall Oaks Pkwy
High Point, NC 27265-8034
Phone (336) 822-9671

Other practice location 1

2754 Hwy 68
Suite 111
High Point, NC 27265
Phone (336) 822-9671

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
34D2202973Triad Pediatrics Mendenhall Oaks4012 Mendenhall Oaks Pkwy, High Point, NC 27265Certificate of waiverDec 1, 2026

National Provider Directory

National Provider Directory

Locations

4148 Mendenhall Oaks Pkwy
High Point, NC 27265

2754 NC Highway 68 S
Ste 111
High Point, NC 27265
Phone (336) 802-1111

4012 Mendenhall Oaks Pkwy
High Point, NC 27265
Phone (336) 802-1111

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1407355704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4148 MENDENHALL OAKS PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658034",
            "telephone_number": "336-822-9671",
            "fax_number": "336-882-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 MENDENHALL OAKS PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658076",
            "telephone_number": "336-822-9671",
            "fax_number": "336-882-2824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2754 HWY 68",
            "address_2": "Suite 111",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "27265",
            "country_code": "US",
            "telephone_number": "336-822-9671",
            "fax_number": "336-882-2824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRIAD PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2021-10-29",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "DILLARD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-822-9671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2007-00476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.