Individual provider Active NPI

Trina M Yenne, APN

  • Women's Health Nurse Practitioner
  • Mount Vernon, IL
National Provider Identifier
1972847309
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
209010025 Issued in IL
Practice address
3130 Veterans Memorial Dr
Mount Vernon, IL 62864-5951
Phone
(618) 997-5266
Fax
(618) 997-5285
NPI assigned
Nov 26, 2012
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209010025 IL Primary

Addresses

Primary practice location

3130 Veterans Memorial Dr
Mount Vernon, IL 62864-5951

Mailing address

1407 McPherson Ave
Mount Vernon, IL 62864-2822
Phone (618) 997-5266

Other practice location 1

1250 W Whittaker St
Salem, IL 62881-1917
Phone (618) 548-3740

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address tyenne337259@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20130506000031 IL Practitioner - Nurse Practitioner 3375780687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Women's Healthcare LTDGroup PAC ID 1759270648, 29 clinicians

Practice addresses (Care Compare)

1007 M L King Dr
Centralia, IL 62801-3001
Phone (618) 997-5266

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Women's Healthcare LTD CurrentSince Jan 1, 2014 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Jan 5, 2020 Accepting new patients
Heartland Women's Healthcare LTD CurrentSince Jan 1, 2014 Accepting new patients
Heartland Women's Healthcare Il PC Past Accepting new patients

Locations

201 Bailey Ln
Benton, IL 62812
Phone (618) 438-3113

900 E Walnut St
Ste 10
Carbondale, IL 62901

811 Fairfax St
Carlyle, IL 62231
Phone (618) 594-3025

24 Veterans Dr
Harrisburg, IL 62946

3408 Office Park Dr
Marion, IL 62959
Phone (618) 977-5266

1407 McPherson Ave
Mount Vernon, IL 62864
Phone (618) 244-1178

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

3130 Veterans Memorial Dr
Mount Vernon, IL 62864
Phone (708) 736-1727

3230 Veterans Memorial Dr
Mount Vernon, IL 62864

1250 W Whittaker St
Salem, IL 62881
Phone (618) 548-3740

1170 Fortune Blvd
Shiloh, IL 62269
Phone (844) 872-6249

1 Broadway Plz
Ste 1
Sparta, IL 62286

6 Park Pl
Swansea, IL 62226
Phone (618) 233-0522

723 Station Xing
Waterloo, IL 62298
Phone (618) 939-1551

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

Interoperability endpoints

  • Direct secure messaging: trina.yenne.1@21608.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1972847309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 MCPHERSON AVE",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642822",
            "telephone_number": "618-997-5266",
            "fax_number": "618-997-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628645951",
            "telephone_number": "618-997-5266",
            "fax_number": "618-997-5285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 W Whittaker St",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "IL",
            "postal_code": "628811917",
            "country_code": "US",
            "telephone_number": "618-548-3740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YENNE",
        "first_name": "TRINA",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209010025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1250 W Whittaker St",
            "city": "Salem",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628811917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyenne337259@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tyenne337259@direct-ehr-ssmhc.com",
            "address_1": "1250 W Whittaker St",
            "city": "Salem",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628811917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.