NPIMap

Organization Active NPI

Triad Radiology Associates, PLLC

  • Vascular & Interventional Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1447368659
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
TRIAD RADIOLOGY ASSOCIATES, PLLC
Practice address
3015 Maplewood Ave Ste 200
Winston Salem, NC 27103-4075
Phone
(336) 794-4188
NPI assigned
Aug 28, 2006
Last updated
Apr 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
TRIAD RADIOLOGY ASSOCIATES, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Authorized official

Name
Darlene Clagett
Title
Director
Phone
(336) 970-5318

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X NC Primary

Addresses

Primary practice location

3015 Maplewood Ave Ste 200
Winston Salem, NC 27103-4075

Mailing address

3010 Trenwest Dr
Winston Salem, NC 27103-3208
Phone (336) 718-5844

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061120000009 NC Part B Supplier - Clinic/Group Practice 8729086194 Receives reassigned benefits from 90 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Triad Radiology Assoc PLLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 67

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 67

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523836800000",
    "number": "1447368659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 TRENWEST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033208",
            "telephone_number": "336-718-5844",
            "fax_number": "336-970-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 MAPLEWOOD AVE STE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034075",
            "telephone_number": "336-794-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD RADIOLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIAD RADIOLOGY ASSOCIATES, PLLC",
        "enumeration_date": "2006-08-28",
        "last_updated": "2018-04-16",
        "status": "A",
        "authorized_official_last_name": "CLAGETT",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-970-5318"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.