Individual provider Active NPI

Mark Allen Karrels, DDS

  • General Practice Dentistry
  • Janesville, WI
National Provider Identifier
1790892263
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5002060G Issued in WI
Practice address
2130 Kennedy Rd
Janesville, WI 53545-0887
Phone
(608) 752-7452
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5002060G WI Primary

Addresses

Primary practice location

2130 Kennedy Rd
Janesville, WI 53545-0887

Mailing address

2130 Kennedy Rd
Janesville, WI 53545-0887
Phone (608) 752-7452

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180524001052 WI Order and Referring Only - DentistPractitioner - Dentist 4082904784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5002060GWIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Trimark Dental Clinic, LLP General Practice 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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790892263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 KENNEDY RD",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450887",
            "telephone_number": "608-752-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 KENNEDY RD",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450887",
            "telephone_number": "608-752-7452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARRELS",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5002060G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.