Individual provider Active NPI

Trina Elaine Ryan, FNP

  • Family Nurse Practitioner
  • Milan, TN
National Provider Identifier
1265859433
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18589 Issued in TN
Practice address
4039 Highland St
Milan, TN 38358-3483
Phone
(731) 422-0213
Fax
(731) 686-8997
NPI assigned
Mar 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 18589 TN Primary

Addresses

Primary practice location

4039 Highland St
Milan, TN 38358-3483

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 422-0213

Other identifiers 2

IdentifierTypeStateIssuer
APN18589OtherTNADVANCE PRACTICE STATE LICENSE
RN0000101400OtherTNSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20140509001062 TN Practitioner - Nurse Practitioner 4082847454

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

176 W University Pkwy C
Jackson, TN 38305-1618

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18589TNMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greene Behavioral Health, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1265859433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-422-0213",
            "fax_number": "731-686-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 HIGHLAND ST",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "383583483",
            "telephone_number": "731-422-0213",
            "fax_number": "731-686-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TRINA",
        "middle_name": "ELAINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCE PRACTICE STATE LICENSE",
            "identifier": "APN18589",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN0000101400",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milan, TN

Sources for this page

Verify at the official NPI Registry.