NPIMap

Organization Active NPI

Triad Imaging LLC

  • Diagnostic Radiology Physician
  • Greensboro, NC
National Provider Identifier
1790743078
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TRIAD IMAGING LLC
Practice address
2705 Henry St
Greensboro, NC 27405-3669
Phone
(336) 272-2162
Fax
(336) 272-2876
NPI assigned
May 3, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Geoffrey K. Gardner
Title
SVP Finance and Revenue Cycle
Phone
(336) 718-2078

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1049372Triad Imaging Inc2705 Henry St, Greensboro, NC 27405Certificate of waiverDec 3, 2027

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20071020000148 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3779551437 Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Locations

1124 N Church St
Ste 100B
Greensboro, NC 27401
Phone (336) 272-2162

3515 W Market St
Ste 320
Greensboro, NC 27403
Phone (336) 660-5420

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X NC Primary

Addresses

NPPES NPI Registry

Primary practice location

2705 Henry St
Greensboro, NC 27405-3669

Mailing address

PO Box 603543
Charlotte, NC 28260-3543
Phone (678) 393-5600

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
371938100OtherNCDOL
890135UMedicaidNC
0135UOtherNCBCBS NC
470000864OtherMEDICARE RR

Other names 1

NPPES NPI Registry
  • Novant Health Imaging Triad Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 19, 2024.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1790743078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603543",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603543",
            "telephone_number": "678-393-5600",
            "fax_number": "770-300-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 HENRY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053669",
            "telephone_number": "336-272-2162",
            "fax_number": "336-272-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "SVP FINANCE AND REVENUE CYCLE",
        "authorized_official_telephone_number": "336-718-2078",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "371938100",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890135U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "0135U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "470000864",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Imaging Triad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.