Individual provider Active NPI

Trevor Richard Neal, DPM

  • Podiatrist
  • Sturgis, MI
National Provider Identifier
1255319059
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
001392 Issued in MI
Practice address
102 S Lakeview St
Sturgis, MI 49091-1947
Phone
(269) 651-2320
Fax
(269) 659-4704
NPI assigned
Jan 3, 2006
Last updated
Jan 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 001392 MI Primary

Addresses

Primary practice location

102 S Lakeview St
Sturgis, MI 49091-1947

Mailing address

102 S Lakeview
PO Box 730
Sturgis, MI 49091
Phone (269) 651-2320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091203000233 MI Practitioner - Podiatry 2365543451 Reassigns benefits to 1 organization
I20161010001917 IN Practitioner - Podiatry 2365543451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001392MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanas Foot & Ankle Specialists PLC Podiatrist CurrentSince Dec 1, 2010 Accepting new patients

Locations

3250 Intertech Dr
Ste B
Angola, IN 46703
Phone (260) 347-2833

102 S Lakeview Ave
Sturgis, MI 49091
Phone (269) 651-2320

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1255319059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S LAKEVIEW",
            "address_2": "PO BOX 730",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "49091",
            "telephone_number": "269-651-2320",
            "fax_number": "269-659-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S LAKEVIEW ST",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490911947",
            "telephone_number": "269-651-2320",
            "fax_number": "269-659-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "TREVOR",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "001392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgis, MI

Sources for this page

Verify at the official NPI Registry.