Trident Medical Group PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TRIDENT MEDICAL GROUP PA

Practice address

3372 Peachtree Road
Suite 115
Atlanta, GA 30326

Phone

(855) 770-7771

Fax

(415) 808-6405

NPI assigned

Dec 27, 2021

Last updated

Nov 14, 2022By 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

Devion Smith

Title

Director, Payer Contracting

Phone

(424) 326-8711

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1699435081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 NE 191ST ST, PMB 75481",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331793899",
            "telephone_number": "310-626-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3372 PEACHTREE ROAD",
            "address_2": "SUITE 115",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30326",
            "telephone_number": "855-770-7771",
            "fax_number": "415-808-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-27",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DEVION",
        "authorized_official_title_or_position": "DIRECTOR, PAYER CONTRACTING",
        "authorized_official_telephone_number": "424-326-8711"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Public Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sloan Trice
• Zakeya Trice
• Shirley D Triche, N.P.
• Trickstrong, LLC
• Trident Medical Group
• Tridentcare Health Services, Inc.
• Anh Van Trieu, PA-C
• Elissa Trieu
• Trillionheir Holdings LLC (Trillion Diagnostics)
• Trimark Health Services Inc

• Internal Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.