Trisha Melissa Wickman, DNP, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Bark River, MI
NPI 1972084580 · NPPES record last updated Aug 22, 2018
Key facts
- NPI
- 1972084580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704210330 (MI)
- Practice address
- 2648 State Highway M35
Bark River, MI 49807-9727 - Phone
- (906) 399-9605
- NPI assigned
- Aug 22, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northern Michigan Emergency Physicians LLP
Sound Inpatient Physicians-Michigan PLLC
St Francis Hospital
Practice addresses (Care Compare)
2463 S M
Suite 30
West Branch, MI 48661-9312
Phone (517) 345-3660
3401 Ludington St
Escanaba, MI 49829-1300
Phone (906) 786-5707
3409 Ludington St
Suite 104
Escanaba, MI 49829-4213
Phone (906) 786-8343
Hospital & facility affiliations
- Osf St Francis Hospital and Medical Group
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190109002984 | MI | Practitioner - Nurse Practitioner | 9537405782 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Francis Hospital | Current |
Accepting new patients | |
| St. Francis Hospital | Current | Accepting new patients | |
| Northern Michigan Emergency Physicians, LLP | Current |
Accepting new patients | |
| Northern Michigan Emergenc Physicians, LLP | Current |
Accepting new patients | |
| St. Francis Hospital | Current |
Accepting new patients | |
| Sound Inpatient Physicians-Michigan, PLLC | Current | Accepting new patients |
Locations
3401 Ludington St
Escanaba, MI 49829
Phone (906) 786-3311
3409 Ludington St
Ste 203
Escanaba, MI 49829
Phone (906) 428-5403
3409 Ludington St
Ste 104
Escanaba, MI 49829
Phone (906) 786-8343
580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131
2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704210330 | MI | Yes |
Addresses
Primary practice location
2648 State Highway M35
Bark River, MI 49807-9727
Mailing address
2648 State Highway M35
Bark River, MI 49807-9727
Phone (906) 399-9605
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4704210330 | Other | MI | APRN LICENSE |
Other providers in Bark River, MI
All providers in Bark River, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.