Individual provider Active NPI

Trina D Ondrizek, FNP-BC

  • Family Nurse Practitioner
  • Mt Juliet, TN
National Provider Identifier
1700109550
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16933 Issued in TN
Practice address
660 S Mount Juliet Rd Ste 210
Mt Juliet, TN 37122-3973
Phone
(615) 443-0901
Fax
(615) 443-0310
NPI assigned
Mar 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 137663 TX
Family Nurse Practitioner 363LF0000X 18670 CA
Family Nurse Practitioner 363LF0000X 16933 TN Primary

Addresses

Primary practice location

660 S Mount Juliet Rd Ste 210
Mt Juliet, TN 37122-3973

Mailing address

53 Century Blvd Ste 120
Nashville, TN 37214-3693
Phone (615) 346-6213

Other practice location 1

2690 Madison St
Suite 130
Clarksville, TN 37043-5975
Phone (931) 245-1701

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
I20130115000042 TN Practitioner - Nurse Practitioner 3476706821 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18670CAMDPediatric Occupational Therapist
137663TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC Nurse Practitioner CurrentSince Dec 10, 2019 Accepting new patients
Clarksville Sportsmed & Wellness Family Past Accepting new patients

Locations

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Organizations & group practices 2

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": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1700109550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CENTURY BLVD STE 120",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143693",
            "telephone_number": "615-346-6213",
            "fax_number": "615-346-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S MOUNT JULIET RD STE 210",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371223973",
            "telephone_number": "615-443-0901",
            "fax_number": "615-443-0310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2690 Madison St",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370435975",
            "country_code": "US",
            "telephone_number": "931-245-1701",
            "fax_number": "931-245-1720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONDRIZEK",
        "first_name": "TRINA",
        "middle_name": "D",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "137663",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18670",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Juliet, TN

Sources for this page

Verify at the official NPI Registry.