Individual provider Active NPI

Tristen Renea Reesor, APRN, FNP-C

  • Family Nurse Practitioner
  • Shepherdsville, KY
National Provider Identifier
1962295212
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4040856 Issued in KY
Practice address
189 Adam Shepherd Pkwy Ste 14
Shepherdsville, KY 40165-6579
Phone
(502) 531-9823
Fax
(502) 215-6138
NPI assigned
May 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4040856 KY Primary

Addresses

Primary practice location

189 Adam Shepherd Pkwy Ste 14
Shepherdsville, KY 40165-6579

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

Other practice location 1

234 Eastbrooke Pkwy
Mount Washington, KY 40047-5600
Phone (502) 538-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250717004284 KY Practitioner - Nurse Practitioner 3072029024 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360Care Services of Kentucky LLCGroup PAC ID 9931587888, 17 clinicians

Practice addresses (Care Compare)

4350 Brownsboro Rd
Suite 200
Louisville, KY 40207-1681
Phone (248) 528-2116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4040856KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Sep 15, 2025 Accepting new patients
360Care Services of Kentucky LLC Current Accepting new patients
360Care Services of Kentucky LLC CurrentSince Jun 15, 2025 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

12910 Shelbyville Rd
Ste 110
Louisville, KY 40243

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

4350 Brownsboro Rd
Ste 200
Louisville, KY 40207
Phone (513) 771-7483

234 Eastbrooke Pkwy
Mt Washington, KY 40047
Phone (502) 538-1241

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1962295212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 ADAM SHEPHERD PKWY STE 14",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401656579",
            "telephone_number": "502-531-9823",
            "fax_number": "502-215-6138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Eastbrooke Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mount Washington",
            "state": "KY",
            "postal_code": "400475600",
            "country_code": "US",
            "telephone_number": "502-538-3050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REESOR",
        "first_name": "TRISTEN",
        "middle_name": "RENEA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-28",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4040856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

Verify at the official NPI Registry.