Trena Phillips, FNP-C
Individual provider Active NPI Family Nurse Practitioner · American Falls, ID
NPI 1255819942 · NPPES record last updated Apr 26, 2019
Key facts
- NPI
- 1255819942
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CNP59395 (ID)
- Practice address
- 502 Tyhee Ave
American Falls, ID 83211-1224 - Phone
- (208) 226-3200
- NPI assigned
- Aug 3, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urgent Care of Idaho LLC
Practice addresses (Care Compare)
1225 S Lincoln Ave
Jerome, ID 83338-3036
Phone (208) 324-2004
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190129003202 | ID | Practitioner - Nurse Practitioner | 0143567131 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP59395 | ID | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care of Idaho, LLC | Current |
Accepting new patients | |
| Urgent Care of Idaho, LLC | Current |
Accepting new patients | |
| River View Urgent Care & Medical Center Inc | Current |
Accepting new patients |
Locations
382 N Overland Ave
Burley, ID 83318
Phone (208) 378-7700
133 W Avenue A
#B
Jerome, ID 83338
Phone (208) 324-2004
2392 Addison Ave E
Twin Falls, ID 83301
Phone (208) 933-2050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | CNP59395 | ID | Yes |
Addresses
Primary practice location
502 Tyhee Ave
American Falls, ID 83211-1224
Mailing address
510 Roosevelt St
American Falls, ID 83211-1362
Phone (208) 226-1057
Other practice location 1
50 S Main St
Aberdeen, ID 83210
Phone (208) 226-1058
Other practice location 2
510 Roosevelt St
American Falls, ID 83211-1362
Phone (208) 226-1057 ext. 503
Other providers in American Falls, ID
- Evelyn Michaelson
- Gregory Allen Miller
- Ronald K. Miller
- Northwest Therapy Services, Inc.
- Linda Parrish
- Power County Dental Clinic
- Power County Hospital
- Power County Hospital
- Power County Hospital District
- Power County Hospital District
All providers in American Falls, ID · Family Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.