Triumph LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

TRIUMPH LLC

Practice address

207 10TH St
Suite 201
N. Wilkesboro, NC 28659-4153

Phone

(336) 667-1440

Fax

(336) 667-1489

NPI assigned

Jan 25, 2007

Last updated

Mar 2, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

TRIUMPH, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Talesha Rollock

Title

Provider Enrollment Specialist

Phone

(919) 256-0824

Specialties & licenses 3

Addresses

Other identifiers 1

Part of

Triumph LLC

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1962558916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 FAIRHILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123215",
            "telephone_number": "919-256-0824",
            "fax_number": "919-256-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 10TH ST",
            "address_2": "SUITE 201",
            "city": "N. WILKESBORO",
            "state": "NC",
            "postal_code": "286594153",
            "telephone_number": "336-667-1440",
            "fax_number": "336-667-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUMPH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIUMPH, LLC",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "ROLLOCK",
        "authorized_official_first_name": "TALESHA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "919-256-0824",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905083",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel H. Swofford, MD
• Lynne Taras
• Heather Norene Thornburg, NP
• Triad Therapy Mental Health Center
• Triumph LLC
• Triumph, LLC
• Valley Radiology Associates, PA
• Voca Corporation of North Carolina, Inc.
• Ryan Ward
• Jerry Franklin Watson, MD

• Psychiatry Physician in N Wilkesboro, NC
• Providers in N Wilkesboro, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.