Active NPI
Trevor Andrew Ervin, CNP
- Nurse Practitioner
- Jackson, OH
National Provider Identifier
1619721933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F07230401
- Practice address
- 4550 Bert Harrold Rd
Jackson, OH 45640-4300 - Phone
- (740) 418-7638
- NPI assigned
- Apr 15, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.441824 | OH | |
| Nurse Practitioner | 363L00000X | F07230401 | OH | Primary |
Addresses
Primary practice location
4550 Bert Harrold Rd
Jackson, OH 45640-4300
Mailing address
4550 Bert Harrold Rd
Jackson, OH 45640-4300
Phone (740) 418-7638
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.441824 | OH | MD | Registered Nurse |
| F07230401 | OH | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1619721933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4550 BERT HARROLD RD",
"city": "JACKSON",
"state": "OH",
"postal_code": "456404300",
"telephone_number": "740-418-7638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4550 BERT HARROLD RD",
"city": "JACKSON",
"state": "OH",
"postal_code": "456404300",
"telephone_number": "740-418-7638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERVIN",
"first_name": "TREVOR",
"middle_name": "ANDREW",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-15",
"last_updated": "2024-04-15",
"certification_date": "2024-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.441824",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "F07230401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.