NPIMap

Individual provider Active NPI

Trevor Mattox

  • Emergency Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1710482344
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
04-44599 Issued in KS
Practice address
One Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-4625
NPI assigned
Mar 26, 2018
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 04-44599 KS Primary

Addresses

Primary practice location

One Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

One Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200819001636 NC Practitioner - Emergency Medicine 7911257456
I20210820001563 KS Practitioner - Emergency Medicine 7911257456 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Florida College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Medical Center LLCGroup PAC ID 2668476862, 54 clinicians
Cep America - Kansas LLCGroup PAC ID 3971814286, 59 clinicians

Practice addresses (Care Compare)

1124 W 21St St
Emergency Medicine
Andover, KS 67002-5500
Phone (316) 300-4911

929 N Saint Francis St
Via Christi Hospital St Francis
Wichita, KS 67214-3821
Phone (316) 268-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Regional Medical Center, Inc. Emergency Medicine CurrentSince Apr 8, 2025 Accepting new patients
Cep America - Kansas LLC Emergency Medicine Current Accepting new patients
Kansas Medical Center, LLC CurrentSince Sep 8, 2025 Accepting new patients
Hutchinson Regional Medical Center, Inc. CurrentSince Apr 8, 2025 Accepting new patients
Rock Regional Hospital, LLC CurrentSince Sep 2, 2025 Accepting new patients
Kansas Medical Center LLC Current Accepting new patients
Cep America - Kansas LLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Cep America - Kansas LLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Kansas Medical Center, LLC Current Accepting new patients
Kansas Medical Center, LLC CurrentSince Sep 8, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1124 W 21st St
Andover, KS 67002
Phone (316) 300-4000

3251 N Rock Rd
Derby, KS 67037
Phone (316) 425-2400

1701 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 665-2117

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

3600 E Harry St
Wichita, KS 67218
Phone (316) 268-5426

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1710482344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOX",
        "first_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "04-44599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.