Triumph Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

TRIUMPH PRIMARY CARE LLC

Practice address

413 Pulaski Hwy Ste 201
Joppa, MD 21085-3625

Phone

(410) 593-7556

Fax

(410) 510-7938

NPI assigned

Dec 2, 2019

Organization subpart

No

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

Authorized official

Name

Ikechi Dike

Title

Nurse Practitioner

Phone

(410) 593-7556

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1851938534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 PULASKI HWY STE 201",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853625",
            "telephone_number": "410-593-7556",
            "fax_number": "410-510-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 PULASKI HWY STE 201",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853625",
            "telephone_number": "410-593-7556",
            "fax_number": "410-510-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUMPH PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "DIKE",
        "authorized_official_first_name": "IKECHI",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "410-593-7556"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Daniel Tennis, PT
• Ronald E Thomas, MD
• Lidwine Tohounde
• Christine Tolliver, MS, CCC-SLP
• Trans Personal Phychological Services, Inc
• Elsie Antwiwaa Tweneboah-Koduah, DNP,CRNP,PMHNP
• Walgreen Co
• Walgreen Co.
• Chantel Walker
• Laurice White

• Primary Care Clinic/Center in Joppa, MD
• Providers in Joppa, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.