TRIAD ADULT AND PEDIATRIC MEDICINE, INC. (NPI# 1265592968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265592968 |
| Entity Type | Organization |
| Organization Name | TRIAD ADULT AND PEDIATRIC MEDICINE, INC. |
| Other Organization Name | GUILFORD CHILD HEALTH, INC. |
| Practice Address |
1046 E Wendover Ave Greensboro NC 27405-6712 |
| Practice Telephone | 3362721050 |
| Practice Fax Number | 3362720155 |
| Mailing Telephone | 3362721050 |
| Mailing Fax Number | 3362720155 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2011-08-18 |
| Authorized Official Name | MR. BRIAN K ELLERBY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3362721050 |
| Authorized Official Credential | MSPH, CMPE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 0245J | 01 |
| NC | 6005223 | 05 |
| Other Name | Type Code |
|---|---|
| Guilford Child Health, Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972050979 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 2039 Brentwood St, High Point, NC 27263-1805 | 2016-09-07 |
| 1326348087 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 1439 E Cone Blvd, Greensboro, NC 27405-4533 | 2010-10-28 |
| 1710049986 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 433 W. Meadowview Road, Greensboro, NC 27406-4316 | 2006-12-14 |
| 1831197938 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 433 W Meadowview Road, Greensboro, NC 27406-4316 | 2005-07-12 |
| 1881059723 | Triad Adult and Pediatric Medicine, Inc. | Family Medicine | 1002 S Eugene St, Greensboro, NC 27406-1308 | 2015-12-18 |
| 1063882165 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 1102 E Market St, Greensboro, NC 27401-6056 | 2015-10-01 |
| 1154791424 | Triad Adult and Pediatric Medicine, Inc. | Community/Behavioral Health | 1002 S Eugene St, Greensboro, NC 27406-1308 | 2015-09-30 |
| 1609279504 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 1002 S Eugene St, Greensboro, NC 27406-1308 | 2014-10-06 |
| 1063712727 | Triad Adult and Pediatric Medicine, Inc. | Pharmacy | 1002 S Eugene St, Greensboro, NC 27406-1308 | 2010-10-28 |
| 1548320237 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 400 E Commerce Ave, High Point, NC 27260-5221 | 2006-12-11 |
| Street Address |
1046 E WENDOVER AVE |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27405-6712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417951864 | Marian Earls | Pediatrics | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2005-06-13 |
| 1871117135 | Max Wilmot | Pediatrics | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2020-06-02 |
| 1194283325 | Lauren Leeanne Poleto | Registered Nurse | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2019-03-06 |
| 1881148542 | Athena Theodora Samaras | Nurse Practitioner | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2016-08-11 |
| 1548679749 | Triad Adult and Pediatric Med-gch Wendover Pharmacy | Pharmacy | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2014-08-13 |
| 1235483785 | Triad Adult and Pediatric Medicine Inc | Pharmacy | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2012-11-06 |
| 1992058531 | Sharon Elizabeth Dempsey | Social Worker | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2012-10-19 |
| 1437412863 | Channel Dion Dobson | Registered Nurse | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2012-06-20 |
| 1386921476 | Jasmine Williams | Social Worker | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2011-11-03 |
| 1538453055 | Amy Hallisey | Pharmacist | 1046 E Wendover Ave, Greensboro, NC 27405-6712 | 2011-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477038727 | Miya Jackson | Behavior Technician | 2308 Golden Gate Dr, Apt G, Greensboro, NC 27405 | 2018-10-02 |
| 1821576299 | Woodrow Eric Bradley | Day Training/Habilitation Specialist | 1403 Woocbriar Ave, Greensboro, NC 27405 | 2018-07-30 |
| 1922593094 | Constance Foushee | Nurse Practitioner | 1100 E. Wendover, Greensboro, NC 27405 | 2018-06-29 |
| 1760972434 | Ayana Linette Holland | Home Health Aide | 1417 Old Hickory Dr, Greensboro, NC 27405 | 2018-05-17 |
| 1790294700 | G. Antoine Gray | Specialist | 2100 Phillips Avenue, Suite B, Greensboro, NC 27405 | 2017-09-21 |
| 1306375910 | Wendy Carisa Boger | Registered Nurse | 1100 East Wendover Avenue, Greensboro, NC 27405 | 2017-06-07 |
| 1659827715 | Changing Paths Counseling Center Pllc | Community/Behavioral Health | 1600 E Wendoer Ave., Suite C, Greensboro, NC 27405 | 2016-08-29 |
| 1295187896 | Amanda Kirby Counseling, PC | Counselor | 1175 Revolution Mill Drive, Suite 29-2, Greensboro, NC 27405 | 2016-07-07 |
| 1780049429 | Pta | Residential Treatment Facility, Physical Disabilities | 1900 Sheldon Road, Greensboro, NC 27405 | 2015-12-23 |
| 1841655644 | Amaya Nicole Hardy | Counselor | 1600r E Wendover Ave Ste R, Greensboro, NC 27405 | 2015-12-21 |
| Find all providers in zip 27405 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326348087 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 1439 E Cone Blvd, Greensboro, NC 27405-4533 | 2010-10-28 |
| 1710049986 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 433 W. Meadowview Road, Greensboro, NC 27406-4316 | 2006-12-14 |
| 1285655936 | Whatley Health Services Inc | Clinic/Center | 800 Hall St, Greensboro, AL 36744 | 2006-07-21 |
| 1831197938 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 433 W Meadowview Road, Greensboro, NC 27406-4316 | 2005-07-12 |
| 1144771106 | Oconee Valley Healthcare Inc | Clinic/Center | 1040 Park Dr, Greensboro, GA 30642 | 2016-10-14 |
| 1063882165 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 1102 E Market St, Greensboro, NC 27401-6056 | 2015-10-01 |
| 1609279504 | Triad Adult and Pediatric Medicine, Inc. | Clinic/Center | 1002 S Eugene St, Greensboro, NC 27406-1308 | 2014-10-06 |
| 1831441104 | Cornerstone Car Inc. | Clinic/Center | 7 Glassworks Rd, Greensboro, PA 15338-9507 | 2012-10-10 |
| 1215288774 | Cornerstone Care Inc. | Clinic/Center | 7 Glassworks Rd, Greensboro, PA 15338-9507 | 2012-09-25 |
| 1407139439 | Cornerstone Care Inc. | Clinic/Center | 7 Glassworks Rd, Greensboro, PA 15338-9507 | 2011-09-26 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.