Trinity Hematology & Oncology Center PA

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

9701004 Issued in NC

Legal business name

TRINITY HEMATOLOGY & ONCOLOGY CENTER PA

Practice address

1209 Cape CT
Fayetteville, NC 28304-4404

Phone

(910) 485-7003

Fax

(910) 485-7103

NPI assigned

Jun 23, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Mark Ketheeswaran, MD

Title

Attending Physician

Phone

(910) 485-7003

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Markandu Ketheeswaran, MD

  • Hematology & Oncology Physician
  • Fayetteville, NC
  • NPI 1487608725
  Medicare reassignment NPD

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1215933239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87427",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047427",
            "telephone_number": "910-485-7003",
            "fax_number": "910-485-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 CAPE CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044404",
            "telephone_number": "910-485-7003",
            "fax_number": "910-485-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEMATOLOGY & ONCOLOGY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "KETHEESWARAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ATTENDING PHYSICIAN",
        "authorized_official_telephone_number": "910-485-7003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "9701004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901814",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "01814",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yineiry Triguero, LCSW
• Trillium Medical Partners PC
• Carol Trimmer
• My Trinh, D.D.S
• Trinity Behavioral Healthcare PC
• Trinity Innovative Programming Services, Inc.
• Trinity Innovative Programming Services, Inc.
• Trinity Medical Equipment and Supplies
• Rebecca Trinkner, LPN
• Denis Trinnel, DO

• Hematology & Oncology Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.