Individual provider Active NPI

Jill Brown Trull, DC

  • Chiropractor
  • Kannapolis, NC
National Provider Identifier
1003881087
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1438 Issued in NC
Practice address
1739 Dale Earnhardt Blvd
Kannapolis, NC 28083-2102
Phone
(704) 938-1141
Fax
(704) 938-1143
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1438 NC Primary

Addresses

Primary practice location

1739 Dale Earnhardt Blvd
Kannapolis, NC 28083-2102

Mailing address

1739 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 938-1141

Other identifiers 2

IdentifierTypeStateIssuer
08849OtherNCBCBSNC
8908849MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100908000286 NC Practitioner - Chiropractic 7719001155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1438NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cannon Chiropractic PLLC Chiropractor CurrentSince Jan 29, 2023 Accepting new patients

Locations

1739 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 323-7991

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1003881087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 DALE EARNHARDT BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "28083",
            "telephone_number": "704-938-1141",
            "fax_number": "704-938-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 DALE EARNHARDT BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280832102",
            "telephone_number": "704-938-1141",
            "fax_number": "704-938-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRULL",
        "first_name": "JILL",
        "middle_name": "BROWN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "08849",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908849",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.