Triad Medicine and Pediatric Associates, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TRIAD MEDICINE AND PEDIATRIC ASSOCIATES, PLLC

Practice address

217 Turner Dr Ste F
Reidsville, NC 27320-5754

Phone

(336) 634-3902

Fax

(336) 634-3933

NPI assigned

Aug 11, 2006

Last updated

Oct 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathleen Halm, MBA

Title

Practice Administrator

Phone

(336) 634-3902

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223856000000",
    "number": "1982615282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 TURNER DR STE F",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205754",
            "telephone_number": "336-634-3902",
            "fax_number": "336-634-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 TURNER DR STE F",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205754",
            "telephone_number": "336-634-3902",
            "fax_number": "336-634-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD MEDICINE AND PEDIATRIC ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-10-13",
        "status": "A",
        "authorized_official_last_name": "HALM",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-634-3902",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Reidsville, NC
• Providers in Reidsville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; 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.