Organization Active NPI

Tree Trail Medical, LLC

  • Chiropractor
  • Norcross, GA
National Provider Identifier
1750461752
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005852 Issued in GA
Legal business name
TREE TRAIL MEDICAL, LLC
Practice address
1250 Tech Dr Ste 460
Norcross, GA 30093-6245
Phone
(770) 638-7246
Fax
(770) 806-0991
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Kevin T Larson, D.C.NPI 1659644409
Title
Owner
Phone
(770) 638-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CHIR005852 GA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 038843 GA

Addresses

Primary practice location

1250 Tech Dr Ste 460
Norcross, GA 30093-6245

Mailing address

1250 Tech Dr Ste 460
Norcross, GA 30093-6245
Phone (770) 638-7246

National Provider Directory

National Provider Directory

Locations

1250 Tech Dr
Ste 460
Norcross, GA 30093
Phone (770) 638-7246

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1750461752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 TECH DR STE 460",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300936245",
            "telephone_number": "770-638-7246",
            "fax_number": "770-806-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 TECH DR STE 460",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300936245",
            "telephone_number": "770-638-7246",
            "fax_number": "770-806-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE TRAIL MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-638-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005852",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "038843",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.