Individual provider Active NPI

Trenton Trey Titsworth, APN

  • Family Nurse Practitioner
  • Olney, IL
National Provider Identifier
1053039610
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209025630 Issued in IL
Practice address
800 E Locust St
Olney, IL 62450-2553
Phone
(618) 395-2131
NPI assigned
Aug 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 209025630 IL Primary

Addresses

Primary practice location

800 E Locust St
Olney, IL 62450-2553

Mailing address

307 E Highland Ave
Robinson, IL 62454-2608
Phone (618) 554-3074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20221101000332 IL Practitioner - Nurse Practitioner 9931576121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland Memorial Hospital IncGroup PAC ID 3870565732, 107 clinicians

Practice addresses (Care Compare)

800 E Locust St
Olney, IL 62450-2553
Phone (618) 395-7340

Hospital & facility affiliations

  • Carle Richland Memorial Hospital Hospital, Olney, IL, CCN 141355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Memorial Hospital, Inc. CurrentSince Oct 10, 2022 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Oct 10, 2022 Accepting new patients

Locations

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

Interoperability endpoints

  • Direct secure messaging: ttitsworth293082@carlehiedirect.net

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 1

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1053039610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E HIGHLAND AVE",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624542608",
            "telephone_number": "618-554-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E LOCUST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502553",
            "telephone_number": "618-395-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITSWORTH",
        "first_name": "TRENTON",
        "middle_name": "TREY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, IL

Sources for this page

Verify at the official NPI Registry.