Individual provider Active NPI

Trisha Rene Hutton, ACNP

  • Gerontology Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1801936513
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209030762 Issued in IL
Practice address
940 E Hattie Greene
Flagstaff, AZ 86001-1918
Phone
(928) 607-2607
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN094538 AZ
Acute Care Nurse Practitioner 363LA2100X AP5442 AZ
Gerontology Nurse Practitioner 363LG0600X 209030762 IL Primary

Addresses

Primary practice location

940 E Hattie Greene
Flagstaff, AZ 86001-1918

Mailing address

940 E Hattie Greene
Flagstaff, AZ 86001-1918
Phone (928) 607-2607

Other identifiers 1

IdentifierTypeStateIssuer
903354MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141016002354 AZ Practitioner - Nurse Practitioner 1254552227 Reassigns benefits to 1 organization
Practice locations: Flagstaff, AZ
I20241024002806 IL Practitioner - Nurse Practitioner 1254552227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209030762ILMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
Northern Arizona Healthcare Corporation Internal Medicine CurrentSince Nov 3, 2018 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Nov 3, 2018 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1485 N Turquoise Dr
Flagstaff, AZ 86001
Phone (928) 774-6626

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2200

515 NE Glen Oak Ave
Ste 202
Peoria, IL 61603
Phone (309) 624-4455

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

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 4

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1801936513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 E HATTIE GREENE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011918",
            "telephone_number": "928-607-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E HATTIE GREENE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011918",
            "telephone_number": "928-607-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTON",
        "first_name": "TRISHA",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "AZ",
            "license": "RN094538",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP5442",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209030762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "903354",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.