NPIMap

Individual provider Active NPI

Mark Henry Knelson, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
National Provider Identifier
1750307559
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
38997 Issued in NC
Practice address
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone
(919) 784-3023
Fax
(919) 784-3497
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 38997 NC Primary

Addresses

Primary practice location

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Mailing address

4020 Westchase Blvd
Suite 390
Raleigh, NC 27607-3938
Phone (919) 834-2767

Other identifiers 1

IdentifierTypeStateIssuer
8949741MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050624000970 NC Practitioner - Diagnostic Radiology 9234174657 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Carolina at Chapel Hill School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Radiologists IncGroup PAC ID 2466355383, 92 clinicians
Durham Radiology Associates IncGroup PAC ID 7719974807, 18 clinicians
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

Practice addresses (Care Compare)

2101 W Arlington Blvd
Suite 210
Greenville, NC 27834-5758
Phone (252) 752-5000

3643 N Roxboro Rd
Durham, NC 27704-2702
Phone (919) 471-4840

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 610-4172

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38997NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Radiologists Inc Diagnostic Radiology CurrentSince Jun 24, 2025 Accepting new patients
Scotland Memorial Hospital Inc Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Durham Radiology Associates, Inc. Diagnostic Radiology CurrentSince Mar 1, 2020 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Sep 1, 2024 Accepting new patients
Raleigh Radiology Wakemed Imaging, LLC Diagnostic Radiology Past Accepting new patients

Locations

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2101 W Arlington Blvd
Ste 210
Greenville, NC 27834
Phone (252) 931-7638

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

630 E 11th St
Washington, NC 27889
Phone (252) 946-2137

Interoperability endpoints

  • Direct secure messaging: mknelson2941557@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: mknelson458494@direct.medicine.duke.edu

Organizations & group practices 5

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 11

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1750307559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 WESTCHASE BLVD",
            "address_2": "SUITE 390",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073938",
            "telephone_number": "919-834-2767",
            "fax_number": "919-834-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3023",
            "fax_number": "919-784-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNELSON",
        "first_name": "MARK",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "38997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8949741",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.