Individual provider Active NPI

Trisha J Fennern, NP-C

  • Family Nurse Practitioner
  • Minot, ND
National Provider Identifier
1013220490
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R30827 Issued in ND
Practice address
1021 20TH Ave SW Ste 113
Minot, ND 58701-6487
Phone
(701) 837-1551
Fax
(701) 837-1540
NPI assigned
Jul 14, 2010
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R30827 ND Primary

Addresses

Primary practice location

1021 20TH Ave SW Ste 113
Minot, ND 58701-6487

Mailing address

1021 20TH Ave SW Ste 113
Minot, ND 58701-6487
Phone (701) 837-1551

Other identifiers 1

IdentifierTypeStateIssuer
84427MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022000298 ND Practitioner - Nurse Practitioner 1850584830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minot Health Clinic, PLLCGroup PAC ID 0143449439, 2 clinicians

Practice addresses (Care Compare)

1021 20TH Ave SW
Suite 113
Minot, ND 58701-6487
Phone (701) 837-1851

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minot Health Clinic, PLLC CurrentSince Jul 1, 2014 Accepting new patients

Locations

1021 20th Ave SW
Ste 113
Minot, ND 58701
Phone (701) 837-1551

1418 S Broadway
Ste B
Minot, ND 58701
Phone (701) 837-1551

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22649/brand/1/csg/1/fhir/r4
  • Direct secure messaging: trisha.fennern@mhc-nd.direct.office.nextgen.com
  • Direct secure messaging: trisha.fennern.1@22649.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1013220490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 20TH AVE SW STE 113",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016487",
            "telephone_number": "701-837-1551",
            "fax_number": "701-837-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 20TH AVE SW STE 113",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016487",
            "telephone_number": "701-837-1551",
            "fax_number": "701-837-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNERN",
        "first_name": "TRISHA",
        "middle_name": "J",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R30827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84427",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.