Individual provider Active NPI

Bryn Trudell, NP

  • Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1740049576
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
363LF0000X Issued in MI
Practice address
1201 E Michigan Ave
Jackson, MI 49201-1852
Phone
(517) 205-1431
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 363LF0000X MI Primary

Addresses

Primary practice location

1201 E Michigan Ave
Jackson, MI 49201-1852

Mailing address

743 Briarcliff Rd
Jackson, MI 49203-3907
Phone (517) 740-8669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240409000565 MI Practitioner - Nurse Practitioner 3274971395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 E Michigan Ave
300 Henry Ford Allegiance Orthopaedics
Jackson, MI 49201-1853
Phone (517) 205-1431

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
363LF0000XMIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Apr 1, 2024 Accepting new patients
W.a. Foote Memorial Hospital, Inc Nurse Practitioner CurrentSince Apr 1, 2024 Accepting new patients
Wa Foote Memorial Hospital, Inc Nurse Practitioner Current Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

1201 E Michigan Ave
Ste 300
Jackson, MI 49201
Phone (517) 205-1431

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

1201 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-1431

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: bwierzbicki453767@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1740049576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 BRIARCLIFF RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033907",
            "telephone_number": "517-740-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011852",
            "telephone_number": "517-205-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDELL",
        "first_name": "BRYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "363LF0000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.