Individual provider Active NPI

Kelsey Norkett Trull, PA

  • Medical Physician Assistant
  • Concord, NC
National Provider Identifier
1508279043
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone
(704) 783-1840
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1070 Vinehaven Dr NE
Concord, NC 28025-2438

Mailing address

4228 Saint Audrey PL
Charlotte, NC 28269-8394
Phone (704) 773-1488

Other identifiers 2

IdentifierTypeStateIssuer
1508279043MedicaidNC
188GMOtherNCBCBS OF NORTH CAROLINA

Other names 1

  • Miss Kelsey Jean Norkett Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905002470 NC Practitioner - Physician Assistant 0547488405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone (704) 783-1840

9965 Poplar Tent Rd
Concord, NC 28027-9304
Phone (704) 783-1833

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Jul 14, 2014 Accepting new patients
Cabarrus Gastroenterology Associates, PLLC Past Accepting new patients
Cabarrus Gastroenterology Associates, PLLC Past Accepting new patients

Locations

1070 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 783-1840

9965 Poplar Tent Rd
Concord, NC 28027
Phone (704) 783-1840

510 Corporate Cir
#1000
Salisbury, NC 28147
Phone (704) 783-1840

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1508279043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 SAINT AUDREY PL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282698394",
            "telephone_number": "704-773-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 VINEHAVEN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252438",
            "telephone_number": "704-783-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRULL",
        "first_name": "KELSEY",
        "middle_name": "NORKETT",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508279043",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NORTH CAROLINA",
            "identifier": "188GM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "NORKETT",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.