NPIMap

Organization Active NPI

Triangle Neuropsychology Services, PLLC

  • Clinical Neuropsychologist
  • Durham, NC
National Provider Identifier
1689625386
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2192 Issued in NC
Legal business name
TRIANGLE NEUROPSYCHOLOGY SERVICES, PLLC
Practice address
3310 Croasdaile Dr
Suite 400
Durham, NC 27705-6806
Phone
(919) 384-9682
Fax
(919) 384-9683
NPI assigned
May 15, 2006
Last updated
Feb 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Authorized official

Name
Dr. Kristine Marie Herfkens, PHDNPI 1023104254
Title
Owner
Phone
(919) 384-9682

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
Clinical Neuropsychologist 103G00000X 2192 NC Primary

Addresses

Primary practice location

3310 Croasdaile Dr
Suite 400
Durham, NC 27705-6806

Mailing address

3310 Croasdaile Dr
Suite 400
Durham, NC 27705-6806
Phone (919) 384-9682

Other identifiers 4

IdentifierTypeStateIssuer
0376XOtherNCBLUE CROSS BLUE SHIELD
974898OtherNCFIRST HEALTH
6000514MedicaidNC
5648716OtherNCAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061205000481 NC Part B Supplier - Clinic/Group Practice 3173522901 Receives reassigned benefits from 8 practitioners
Practice locations: Durham, NC; Raleigh, NC

National Provider Directory

National Provider Directory

Locations

3310 Croasdaile Dr
Ste 400
Durham, NC 27705
Phone (919) 284-9682

Practitioners & affiliated clinicians

Practitioners 10

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": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1689625386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 CROASDAILE DR",
            "address_2": "SUITE 400",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056806",
            "telephone_number": "919-384-9682",
            "fax_number": "919-384-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 CROASDAILE DR",
            "address_2": "SUITE 400",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056806",
            "telephone_number": "919-384-9682",
            "fax_number": "919-384-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIANGLE NEUROPSYCHOLOGY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "HERFKENS",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-384-9682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "2192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0376X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "974898",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000514",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5648716",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.