Individual provider Active NPI

Melissa Jane Trejo

  • Case Manager/Care Coordinator
  • Idabel, OK
National Provider Identifier
1104738996
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
411 S Central Ave
Idabel, OK 74745-6059
Phone
(580) 286-5045
Fax
(580) 286-5721
NPI assigned
Sep 18, 2026
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OK Primary

Addresses

Primary practice location

411 S Central Ave
Idabel, OK 74745-6059

Mailing address

201 White Wolf TRL
Broken Bow, OK 74728-5621
Phone (580) 306-2444

Other practice location 1

128 N 12th Ave
Durant, OK 74701-4718
Phone (580) 745-9276

Other practice location 2

107 S High St
Antlers, OK 74523-3818
Phone (580) 298-2830

Other names 1

  • Melissa Jane Trejo-Mares Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1789689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1104738996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WHITE WOLF TRL",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285621",
            "telephone_number": "580-306-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S CENTRAL AVE",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747456059",
            "telephone_number": "580-286-5045",
            "fax_number": "580-286-5721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 N 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Durant",
            "state": "OK",
            "postal_code": "747014718",
            "country_code": "US",
            "telephone_number": "580-745-9276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 S High St",
            "address_purpose": "LOCATION",
            "city": "Antlers",
            "state": "OK",
            "postal_code": "745233818",
            "country_code": "US",
            "telephone_number": "580-298-2830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREJO",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-18",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "TREJO-MARES",
            "middle_name": "JANE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Idabel, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.