Organization Active NPI

Triton Core Holdings LLC

  • Internal Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1407612641
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TRITON CORE HOLDINGS LLC
Practice address
1500 Centrepark Blvd Apt 729
West Palm Beach, FL 33401-7471
Phone
(734) 686-1517
NPI assigned
Feb 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Ikenna Kingsley NwambaNPI 1356872832
Title
Owner/Provider
Phone
(734) 686-1517

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1500 Centrepark Blvd Apt 729
West Palm Beach, FL 33401-7471

Mailing address

1500 Centrepark Blvd Apt 729
West Palm Beach, FL 33401-7471
Phone (734) 686-1517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240731000061 FL Part B Supplier - Clinic/Group Practice 1557808276 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1407612641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CENTREPARK BLVD APT 729",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334017471",
            "telephone_number": "734-686-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CENTREPARK BLVD APT 729",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334017471",
            "telephone_number": "734-686-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRITON CORE HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "NWAMBA",
        "authorized_official_first_name": "IKENNA",
        "authorized_official_middle_name": "KINGSLEY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "734-686-1517"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.