Active NPI
Mark Patrick Trell, DC
- Chiropractor
- Raleigh, NC
National Provider Identifier
1841494010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- NC1882
- Practice address
- 205 W Millbrook Rd Ste 205
Raleigh, NC 27609-4492 - Phone
- (919) 755-0024
- Fax
- (919) 782-3064
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | NC1882 | NC | Primary |
Addresses
Primary practice location
205 W Millbrook Rd Ste 205
Raleigh, NC 27609-4492
Mailing address
205 W Millbrook Rd Ste 205
Raleigh, NC 27609-4492
Phone (919) 755-0024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0882G | Other | NC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050712000477 | NC | Practitioner - Chiropractic | 1658307608 | Practice locations: Raleigh, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
205 W Millbrook Rd
Raleigh, NC 27609-4492
Phone (919) 755-0024
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC1882 | NC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1841494010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 W MILLBROOK RD STE 205",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276094492",
"telephone_number": "919-755-0024",
"fax_number": "919-782-3064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 W MILLBROOK RD STE 205",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276094492",
"telephone_number": "919-755-0024",
"fax_number": "919-782-3064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRELL",
"first_name": "MARK",
"middle_name": "PATRICK",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "NC1882",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0882G",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.