NPIMap

Individual provider Active NPI

Trent H Nourse, PA-C, MPAS

  • Physician Assistant
  • Fairborn, OH
National Provider Identifier
1821091455
Registry record updated Oct 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.001406RX Issued in OH
Practice address
7774 Dayton Springfield Rd
Fairborn, OH 45324-1957
Phone
(937) 864-7363
Fax
(937) 864-5895
NPI assigned
May 27, 2005
Last updated
Oct 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.001406RX OH Primary

Addresses

Primary practice location

7774 Dayton Springfield Rd
Fairborn, OH 45324-1957

Mailing address

7774 Dayton Springfield Rd
Fairborn, OH 45324-1957
Phone (937) 864-7363

Other practice location 1

2665 Derr Road
Springfield, OH 45503-8620
Phone (937) 342-9801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060217000395 OH Practitioner - Physician Assistant 1850306515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Medicine IncGroup PAC ID 1052363967, 5 clinicians
Mercy Health Physicians Springfield Primary Care LLCGroup PAC ID 7315361359, 37 clinicians

Practice addresses (Care Compare)

7774 Dayton Springfield Rd
Fairborn, OH 45324-1957
Phone (937) 864-7363

900 Scioto St
Suite 4
Urbana, OH 43078-2251
Phone (937) 653-4666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.001406RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Springfield Primary Care LLC Family Medicine CurrentSince Oct 20, 2025 Accepting new patients
Citran Xray LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

7774 Dayton Springfield Rd
Ste C
Fairborn, OH 45324
Phone (937) 340-6261

900 Scioto St
Ste 4
Urbana, OH 43078
Phone (937) 653-4666

Interoperability endpoints

  • Direct secure messaging: tnourse215419@direct.bsmhealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760745600000",
    "number": "1821091455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7774 DAYTON SPRINGFIELD RD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453241957",
            "telephone_number": "937-864-7363",
            "fax_number": "937-864-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7774 DAYTON SPRINGFIELD RD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453241957",
            "telephone_number": "937-864-7363",
            "fax_number": "937-864-5895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2665 Derr Road",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455038620",
            "country_code": "US",
            "telephone_number": "937-342-9801",
            "fax_number": "937-342-9804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOURSE",
        "first_name": "TRENT",
        "middle_name": "H",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.001406RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

Verify at the official NPI Registry.