Individual provider Active NPI

Malcolm Trimble, MD

  • Hematology & Oncology Physician
  • Jackson, MI
National Provider Identifier
1831164375
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MT061391 Issued in MI
Practice address
1100 E Michigan Ave Ste 307
Jackson, MI 49201-1850
Phone
(517) 205-1594
Fax
(517) 205-1540
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MT061391 MI Primary

Addresses

Primary practice location

1100 E Michigan Ave Ste 307
Jackson, MI 49201-1850

Mailing address

1100 E Michigan Ave Ste 307
Jackson, MI 49201-1850
Phone (517) 205-1594

Other identifiers 1

IdentifierTypeStateIssuer
4618060MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mtrimble452939@direct.hfhs.org
Direct Messaging Address mtrimble452939@direct.hfhs.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000524 MI Practitioner - HematologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 6002700614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HematologyAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

1100 E Michigan Ave
Jackson, MI 49201-1850
Phone (517) 205-1594

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT061391MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W. a. Foote Memorial Hospital, Inc Internal Medicine CurrentSince Jan 1, 2010 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jan 1, 2010 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

1100 E Michigan Ave
#S201
Jackson, MI 49201
Phone (517) 789-7122

1100 E Michigan Ave
Ste 307
Jackson, MI 49201
Phone (517) 205-1594

1100 E Michigan Ave
Ste 201
Jackson, MI 49201
Phone (517) 205-7605

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

1100 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-7605

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

Interoperability endpoints

  • Direct secure messaging: mtrimble452939@direct.hfhs.org

Organizations & group practices 3

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 2

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1831164375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE STE 307",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011850",
            "telephone_number": "517-205-1594",
            "fax_number": "517-205-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE STE 307",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011850",
            "telephone_number": "517-205-1594",
            "fax_number": "517-205-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMBLE",
        "first_name": "MALCOLM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "MT061391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4618060",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtrimble452939@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "1100 E Michigan Ave",
            "address_2": "STE 201",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtrimble452939@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "1100 E Michigan Ave Ste 307",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.