Individual provider Active NPI

Kelley Rowan Mark

  • Student in an Organized Health Care Education/Training Program
  • Chapel Hill, NC
National Provider Identifier
1073202719
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
590 Manning Drive
Chapel Hill, NC 27599
Phone
(984) 974-0210
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

590 Manning Drive
Chapel Hill, NC 27599

Mailing address

590 Manning Drive
Chapel Hill, NC 27599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230519001985 NC Order and Referring Only - Family PracticePractitioner - Family Practice 0042676884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: kmark464504@directhisp.wakemed.org
  • Direct secure messaging: kmark1037460@direct.unc.nchie.net

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1073202719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 MANNING DRIVE",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 MANNING DRIVE",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27599",
            "telephone_number": "984-974-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "KELLEY",
        "middle_name": "ROWAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.