Triseasons Healthcare PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

188728 Issued in NC

Legal business name

TRISEASONS HEALTHCARE PLLC

Practice address

101 Alison LN
Archdale, NC 27263-3457

Phone

(336) 883-8633

Fax

(202) 379-1739

NPI assigned

Mar 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. John Clayston Skarda, M.D.

Title

Owner

Phone

(828) 528-1228

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1649513722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ALISON LN",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272633457",
            "telephone_number": "336-883-8633",
            "fax_number": "202-379-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ALISON LN",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272633457",
            "telephone_number": "336-883-8633",
            "fax_number": "202-379-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISEASONS HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "SKARDA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CLAYSTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-528-1228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "188728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8976744",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1659314748",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Archdale, NC
• Providers in Archdale, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.