NPIMap

Individual provider Active NPI

Cristin M Trecroce, DO

  • Family Medicine Physician
  • Elkin, NC
National Provider Identifier
1427020437
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200800369 Issued in NC
Practice address
380 Parkwood Medical Park
Elkin, NC 28621-2444
Phone
(336) 835-9355
Fax
(336) 835-8581
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS010068L PA
Family Medicine Physician 207Q00000X 200800369 NC Primary

Addresses

Primary practice location

380 Parkwood Medical Park
Elkin, NC 28621-2444

Mailing address

PO Box 249
Yadkinville, NC 27055-0249
Phone (336) 679-4963

Other identifiers 3

IdentifierTypeStateIssuer
0018288970004MedicaidPA
232359401OtherPAGREAT VALLEY HEALTH
5910956MedicaidNC

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
200800369NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BRMG-PC Family Medicine Past Accepting new patients
Main Line Healthcare Family Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1427020437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270550249",
            "telephone_number": "336-679-4963",
            "fax_number": "336-679-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 PARKWOOD MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212444",
            "telephone_number": "336-835-9355",
            "fax_number": "336-835-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRECROCE",
        "first_name": "CRISTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010068L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200800369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018288970004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT VALLEY HEALTH",
            "identifier": "232359401",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910956",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkin, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.