NPIMap

Organization Active NPI

Triad Optometric Group PA

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1568564854
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1585 Issued in NC
Legal business name
TRIAD OPTOMETRIC GROUP PA
Practice address
4151Main @ North Hills St
# 100
Raleigh, NC 27609
Phone
(919) 782-9091
NPI assigned
Sep 5, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Timothy MillerNPI 1336107754
Title
President
Phone
(919) 782-9091

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1585 NC Primary

Addresses

Primary practice location

4151Main @ North Hills St
# 100
Raleigh, NC 27609

Mailing address

4151 Main @ North Hills St
# 100
Raleigh, NC 27609
Phone (919) 782-9091

National Provider Directory

National Provider Directory

Locations

4151 Main At North Hills St
Ste 100
Raleigh, NC 27609
Phone (919) 782-9091

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1568564854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 MAIN @ NORTH HILLS ST",
            "address_2": "# 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-782-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151MAIN @ NORTH HILLS ST",
            "address_2": "# 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-782-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD OPTOMETRIC GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-782-9091"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.