Active NPI
David Parrell
- Contractor
- Black Earth, WI
National Provider Identifier
1194066639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 12254-146
- Practice address
- 4744 Blue Mounds TRL
Black Earth, WI 53515-9742 - Phone
- (608) 767-3413
- NPI assigned
- Mar 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 12254-146 | WI | Primary |
Addresses
Primary practice location
4744 Blue Mounds TRL
Black Earth, WI 53515-9742
Mailing address
4744 Blue Mounds TRL
Black Earth, WI 53515-9742
Phone (608) 767-3413
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000113436 | Other | WI | MASSAGE THERAPIST |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12254-146 | WI | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362700800000",
"number": "1194066639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4744 BLUE MOUNDS TRL",
"city": "BLACK EARTH",
"state": "WI",
"postal_code": "535159742",
"telephone_number": "608-767-3413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4744 BLUE MOUNDS TRL",
"city": "BLACK EARTH",
"state": "WI",
"postal_code": "535159742",
"telephone_number": "608-767-3413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARRELL",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-08",
"last_updated": "2013-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WI",
"license": "12254-146",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE THERAPIST",
"identifier": "0000000000113436",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Black Earth, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.