Trisha Wierenga, BSN, RN, IBCLC, RLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209023427 Issued in IL

Practice address

6 Westport CT
Bloomington, IL 61704-8233

Phone

(309) 722-4020

Fax

(309) 740-4440

NPI assigned

May 8, 2014

Last updated

Jul 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

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.

• Bloomington Normal Birthing Center

  • Birthing Clinic/Center
  • Bloomington, IL
  • NPI 1528438512
  NPD (past)

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1932510203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 MARSHALL RD",
            "city": "EUREKA",
            "state": "IL",
            "postal_code": "615301627",
            "telephone_number": "309-370-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WESTPORT CT",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048233",
            "telephone_number": "309-722-4020",
            "fax_number": "309-740-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2016 Marshall Rd",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "IL",
            "postal_code": "615301627",
            "country_code": "US",
            "telephone_number": "309-370-4025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIERENGA",
        "first_name": "TRISHA",
        "credential": "BSN, RN, IBCLC, RLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-08",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "IL",
            "license": "L-35463",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "209023427",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel A Whittle
• Cody Wickenhauser, PT, DPT
• Holly D Wickenhauser, ATC
• Hannah Jean Wieland
• John M. Wieland, M.D.
• Debbie Novtney Wietfeldt, DNP
• Kelly Rebekah Wilkerson Dullenty, D.C.
• Samantha Wilkes, PHARMD
• Kristin N Wilkins, APN-CNS
• Melissa Faye Wilkinson

• Family Nurse Practitioner in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.