Talisha Ettina Leeann Troutt, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

23083 Issued in TN

Practice address

365 Stout Drive
Suite 160
Johnson City, TN 37614-3761

Phone

(423) 439-4225

Fax

(423) 439-4560

NPI assigned

Aug 29, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Tennessee State UniversityGroup PAC ID 2769394774, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• East Tennessee State University

  dba Johnson City Downtown Clinic Day Center

  • Federally Qualified Health Center (FQHC)
  • Johnson City, TN
  • NPI 1093990608
  Medicare reassignment Care Compare group NPD
• East Tennessee State University

  dba Student University Health Services

  • Multi-Specialty Clinic/Center
  • Johnson City, TN
  • NPI 1568570273

  Primary Care

  NPD
• Medical Care PLLC

  • Family Medicine Physician
  • Elizabethton, TN
  • NPI 1851537260
  NPD
• East Tennessee State University

  dba Johnson City Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Johnson City, TN
  • NPI 1477660199
  NPD (past)

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1639696784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70403",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141703",
            "telephone_number": "423-439-4381",
            "fax_number": "423-439-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 STOUT DRIVE",
            "address_2": "SUITE 160",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376143761",
            "telephone_number": "423-439-4225",
            "fax_number": "423-439-4560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Brookside Dr Ste 20",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604658",
            "country_code": "US",
            "telephone_number": "423-247-7030",
            "fax_number": "423-247-7033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "132 Old Gray Station Rd",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "37615",
            "country_code": "US",
            "telephone_number": "423-467-8001",
            "fax_number": "423-467-8003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2151 Century Ln",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376044469",
            "country_code": "US",
            "telephone_number": "423-926-2500",
            "fax_number": "423-926-5999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 S Shady St",
            "address_purpose": "LOCATION",
            "city": "Mountain City",
            "state": "TN",
            "postal_code": "376832021",
            "country_code": "US",
            "telephone_number": "423-727-1150",
            "fax_number": "423-727-1152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TROUTT",
        "first_name": "TALISHA",
        "middle_name": "ETTINA LEEANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "23083",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q036951",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tritenn LLC (Gray Pharmacy)
• Phyllis Jean Trivett, RN
• Prentice Dale Trivette
• Rita M Trivette, NP
• Ryan Trojniar, DO
• Joyce Anne Troxler, MD
• June Gable Troxler, LCSW
• Truelight Eye Care, PLLC
• Elizabeth Ann Truman, FNP-C
• Thomas A Truman, PA-C

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.