Individual provider Active NPI

Douglas Lee Trenkle, DO

  • Internal Medicine Physician
  • Ellsworth, ME
National Provider Identifier
1629017553
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1021 Issued in ME
Practice address
306 Main St
Maine Coast Specialty Clinic
Ellsworth, ME 04605-1510
Phone
(207) 664-5566
Fax
(207) 664-5822
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1021 ME Primary

Addresses

Primary practice location

306 Main St
Maine Coast Specialty Clinic
Ellsworth, ME 04605-1510

Mailing address

50 Union St
Ellsworth Internal Medicine
Ellsworth, ME 04605-1586
Phone (207) 664-5480

Other identifiers 1

IdentifierTypeStateIssuer
238620099MedicaidME

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
1021MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Coast Regional Health Facilities Internal Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1629017553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 UNION ST",
            "address_2": "ELLSWORTH INTERNAL MEDICINE",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051586",
            "telephone_number": "207-664-5480",
            "fax_number": "207-664-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "address_2": "MAINE COAST SPECIALTY CLINIC",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051510",
            "telephone_number": "207-664-5566",
            "fax_number": "207-664-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENKLE",
        "first_name": "DOUGLAS",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "1021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238620099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.