Individual provider Active NPI

Jennifer Trevino, FNP-BC

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1144903386
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1130235 Issued in TX
Practice address
5101 Squaw Creek CT
Fort Worth, TX 76137-3531
Phone
(702) 445-4623
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 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 1130235 TX Primary

Addresses

Primary practice location

5101 Squaw Creek CT
Fort Worth, TX 76137-3531

Mailing address

5101 Squaw Creek CT
Fort Worth, TX 76137-3531
Phone (702) 445-4623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240318001346 TX Practitioner - Nurse Practitioner 6709223423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Practice addresses (Care Compare)

2901 W 7TH Ave
Integrity Urgent Care
Corsicana, TX 75110-4811
Phone (903) 616-0111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DCS Medical PA CurrentSince Mar 1, 2024 Accepting new patients
DCS Medical PA CurrentSince Mar 1, 2024 Accepting new patients

Locations

1115 E Tyler St
Athens, TX 75751
Phone (903) 292-5015

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

2901 W 7th Ave
Corsicana, TX 75110
Phone (903) 616-0111

607 E Malloy Bridge Rd
Seagoville, TX 75159
Phone (469) 908-5018

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1144903386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 SQUAW CREEK CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761373531",
            "telephone_number": "702-445-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 SQUAW CREEK CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761373531",
            "telephone_number": "702-445-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1130235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.