AMANDA LEE TREVINO (FNP) – Family Nurse Practitioner, NPI 1710450762

AMANDA LEE TREVINO (FNP) is a healthcare provider. based in Rogersville, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 2018044128 (MO). The NPI Number for AMANDA LEE TREVINO (FNP) is 1710450762

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA LEE TREVINO (FNP)
NPI
1710450762
Phone
(417) 753-9404
Address
101 S Main St
Enumeration Date
2 January 2019
Last Update Date
21 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8432730376
Graduation Year
2018 (8 years ago)
PAC ID
9032450614
Group Practice PAC ID
2062724602
Professional Enrollment ID
I20200620000005
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for AMANDA LEE TREVINO (FNP)

  • 101 S Main St

    Rogersville, MO 657429357

    Phone: (417) 753-9404

    Fax: (417) 753-9137

    Type: Location

  • 222, East Primrose Street, Springfield, Greene County, Missouri, 65807, United States

    SPRINGFIELD, MO 658075233

    Phone: (417) 888-0167

    Type: Location

  • 1540 E EVERGREEN ST

    SPRINGFIELD, MO 658034300

    Phone: (417) 823-2900

    Fax: (417) 886-2774

    Type: Location

  • 3183, East Liberty Street, Liberty Place, Republic, Greene County, Missouri, 65738, United States

    REPUBLIC, MO 657387826

    Phone: (417) 755-6486

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 76 Open Payments records for all available years, with a total value of $1,113.

Total Amount is formed as General ($1,113) + Research ($0) + Ownership ($0) = $1,113.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Abbott Laboratories ($201).

Total Amount

$1,113

General + Research + Ownership

Payments

76

Total payment records

General Amount

$1,113

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-06-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190409000301INurse PractitionerMOTBD
I20200620000005INurse PractitionerSCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65742)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062724602View full group profile

Reviews

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Frequently asked questions

Is there an official ID for AMANDA LEE TREVINO (FNP) in U.S. healthcare records?
The official identifier for AMANDA LEE TREVINO (FNP) is NPI 1710450762.
Would AMANDA LEE TREVINO (FNP) appear as active to a payer?
You can treat AMANDA LEE TREVINO (FNP) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with AMANDA LEE TREVINO (FNP)?
AMANDA LEE TREVINO (FNP)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is AMANDA LEE TREVINO (FNP) associated with Rogersville?
Public fields place AMANDA LEE TREVINO (FNP) around Rogersville, Missouri. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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