Trident USA Foot Care Services LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

TRIDENT USA FOOT CARE SERVICES LLC

Practice address

800 Tiffany Blvd Ste 101
Rocky Mount, NC 27804-1807

Phone

(252) 985-1371

NPI assigned

Oct 19, 2015

Last updated

Dec 7, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Boes

Title

Coo

Phone

(252) 985-1371

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1457722217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TIFFANY BLVD STE 101",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041807",
            "telephone_number": "252-985-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TIFFANY BLVD STE 101",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041807",
            "telephone_number": "252-985-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT USA FOOT CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "BOES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "252-985-1371"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.