Active NPI
Trina
- Nurse Practitioner
- Cordova, TN
National Provider Identifier
1609267343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 19630
- Legal business name
- TRINA
- Practice address
- 420 S Germantown Pkwy
Suite 112
Cordova, TN 38018-4387 - Phone
- (901) 682-1234
- NPI assigned
- Feb 17, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Megan Reneau
- Title
- Manager
- Phone
- (901) 361-2812
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 19630 | TN | Primary |
Addresses
Primary practice location
420 S Germantown Pkwy
Suite 112
Cordova, TN 38018-4387
Mailing address
1755 Highway 311
Holly Springs, MS 38635-9717
Phone (662) 551-0189
National Provider Directory
National Provider DirectoryLocations
420 S Germantown Pkwy
Ste 112
Cordova, TN 38018
Phone (901) 682-1234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1424131200000",
"number": "1609267343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1755 HIGHWAY 311",
"city": "HOLLY SPRINGS",
"state": "MS",
"postal_code": "386359717",
"telephone_number": "662-551-0189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 S GERMANTOWN PKWY",
"address_2": "SUITE 112",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380184387",
"telephone_number": "901-682-1234"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRINA",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-17",
"last_updated": "2015-02-17",
"status": "A",
"authorized_official_last_name": "RENEAU",
"authorized_official_first_name": "MEGAN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "901-361-2812"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "TN",
"license": "19630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.