Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Trevor Elan Black, DPM

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1861835308

Mr. Trevor Elan Black, DPM is a Podiatry in Atlanta, Georgia. Qualified in 2013, 13 years ago. Practices with Matrix Rehabilitation-Georgia Inc, a 44-clinician group. Licensed in Georgia.

Years since qualifying
13
Licensed in
GA
In the registry since
2013
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

20 Glenlake Pkwy Kaiser Permanente Glenlake Medical Ctr
Atlanta, GA 30328-3473
Phone: (818) 326-1058
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence POD001289 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1861835308
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedApril 15, 2013
Last updated in NPPESJanuary 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Matrix Rehabilitation-Georgia Inc — 44 clinicians
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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