NPIMap

Organization Active NPI

Triad ENT PA

  • Specialist
  • Lexington, NC
National Provider Identifier
1447345616
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
38408 Issued in NC
Legal business name
TRIAD ENT PA
Practice address
106 W Medical Park Dr
Suite C
Lexington, NC 27292-6853
Phone
(336) 249-3551
Fax
(336) 249-2697
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Authorized official

Name
Dr. Michael Jerome Phillips, M.D.NPI 1417919044
Title
Owner
Phone
(336) 249-3551

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 38408 NC Primary

Addresses

Primary practice location

106 W Medical Park Dr
Suite C
Lexington, NC 27292-6853

Mailing address

PO Box 536
Lexington, NC 27293-0536
Phone (336) 249-3551

National Provider Directory

National Provider Directory

Locations

3641A Westgate Center Cir
Winston Salem, NC 27103
Phone (336) 794-0247

Practitioners & affiliated clinicians

Practitioners 2

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1447345616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 536",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272930536",
            "telephone_number": "336-249-3551",
            "fax_number": "336-249-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W MEDICAL PARK DR",
            "address_2": "SUITE C",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926853",
            "telephone_number": "336-249-3551",
            "fax_number": "336-249-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD ENT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-249-3551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "38408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.