Triad Pediatric Therapy, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

TRIAD PEDIATRIC THERAPY, LLC

Practice address

6846 S Canton Ave Ste 120
Tulsa, OK 74136-3412

Phone

(918) 232-3064

NPI assigned

Nov 24, 2021

Organization subpart

No

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

Authorized official

Name

Eddie McCorkle

Title

Ceo

Phone

(918) 232-3064

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1720745755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 S CYPRESS PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126094",
            "telephone_number": "918-232-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6846 S CANTON AVE STE 120",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363412",
            "telephone_number": "918-232-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "MCCORKLE",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-232-3064"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jess Michael Trevino, PHARM.D.
• Trey Trotter, LMFT & Associates, LLC (Trey trotter, LMFT)
• Triad Eye Institute PLLC
• Triad Eye Institute PLLC
• Triad Eye Medical Clinic & Cataract Institute Co Inc
• Triad Surgery Center LLC
• Triad Surgery Center, LLC
• Tribal Bio-Med, LLC
• Lauren Denise Tribbey Lane, M.D.
• Anthony Paul Tricinella, D.O.

• Pediatrics Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.