Triumph LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

TRIUMPH LLC

Practice address

189 Samaritan Ridge Road
Elkin, NC 28621-2452

Phone

(336) 526-8335

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

Brenda Frazier

Title

Provider Enrollment Specialist

Phone

(919) 256-0824

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1972659704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 SAMARITAN RIDGE ROAD",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212452",
            "telephone_number": "336-526-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 SAMARITAN RIDGE ROAD",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212452",
            "telephone_number": "336-526-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUMPH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "919-256-0824"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902796",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Elkin, NC
• Providers in Elkin, 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 Jul 24, 2007; 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.