MARK HENRY KNELSON (NPI# 1750307559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750307559 |
| Entity Type | Individual |
| Full Name | MARK HENRY KNELSON |
| Credential | M.D. |
| Practice Address |
4420 Lake Boone Trl Raleigh NC 27607-7505 |
| Mailing Address |
4020 Westchase Blvd Suite 390 Raleigh NC 27607-3938 |
| Practice Telephone | 9197843023 |
| Practice Fax Number | 9197843497 |
| Mailing Telephone | 9198342767 |
| Mailing Fax Number | 9198340234 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
38997 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8949741 | 05 |
| Street Address |
4420 LAKE BOONE TRL |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-7505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225035405 | Karen Kinney Schneider | Nurse Practitioner | 4420 Lake Boone Trl, Wound Healing Center, Raleigh, NC 27607-7505 | 2005-07-05 |
| 1700486685 | Cameron Blake Little | Nurse Practitioner | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-10-29 |
| 1942811278 | Whitney Dale Marks | Nurse Practitioner | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-08-11 |
| 1447869359 | Daneille Barbara Hamlin | Audiologist | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-07-27 |
| 1427675057 | Robert Brinson Mitchell IIi | Nurse Anesthetist, Certified Registered | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-06-30 |
| 1912523457 | Driss Zine | Nurse Practitioner | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-06-21 |
| 1619599081 | Kai Kang | Pharmacist | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-05-08 |
| 1487281671 | Allison Tharakan | Pharmacist | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-03-26 |
| 1598391435 | Gerald Shane Taylor | Registered Nurse | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-03-22 |
| 1982230140 | Catherine Parks Chantrill | Registered Nurse | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2020-03-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
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| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700497492 | Raleigh Radiology Imaging Network, LLC | Radiology | 505 Oberlin Rd Ste 110, Raleigh, NC 27605-1345 | 2020-08-14 |
| 1598956385 | Athena Radiology Solutions | Radiology | 8309 Six Forks Rd, Suite 101, Raleigh, NC 27615-2096 | 2007-08-06 |
| 1174738082 | Janine Beeson | Radiology | 1121 Situs Ct, Ste 170, Raleigh, NC 27606-4279 | 2007-05-14 |
| 1780669986 | John Andrew Bardini | Radiology | 3200 Blue Ridge Rd, Suite 100, Raleigh, NC 27612-8086 | 2005-12-09 |
| 1699769315 | Richard B Clinton | Radiology | 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 | 2005-09-08 |
| 1689086878 | Ryan Stephens | Radiology | 3949 Browning Pl, Raleigh, NC 27609-6536 | 2014-05-22 |
| 1326468893 | Nicole A Keefe | Radiology | 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 | 2014-04-23 |
| 1750708913 | Ashley Nicole Oladipo | Radiology | 3949 Browning Pl, Raleigh, NC 27609-6536 | 2014-03-26 |
| 1063854354 | Christopher Alan Hallmark | Radiology | 3949 Browning Pl, Raleigh, NC 27609-6536 | 2013-07-26 |
| 1073855318 | Sejal Narendra Patel | Radiology | 3400 Wake Forest Rd, Raleigh, NC 27609 | 2013-03-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.