Individual provider Active NPI

Randolph N. Truitt Jr., PA-C

  • Medical Physician Assistant
  • Coatesville, PA
National Provider Identifier
1205945219
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA000207L Issued in PA
Practice address
1400 Blackhorse Hill Rd
Coatesville V.a. Medical Center
Coatesville, PA 19320-2040
Phone
(610) 384-7711
Fax
(610) 380-4318
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA000207L PA Primary

Addresses

Primary practice location

1400 Blackhorse Hill Rd
Coatesville V.a. Medical Center
Coatesville, PA 19320-2040

Mailing address

1400 Blackhorse Hill Rd
Coatesville V.a. Medical Center
Coatesville, PA 19320-2040
Phone (610) 384-7711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1205945219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BLACKHORSE HILL RD",
            "address_2": "COATESVILLE V.A. MEDICAL CENTER",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193202040",
            "telephone_number": "610-384-7711",
            "fax_number": "610-380-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BLACKHORSE HILL RD",
            "address_2": "COATESVILLE V.A. MEDICAL CENTER",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193202040",
            "telephone_number": "610-384-7711",
            "fax_number": "610-380-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUITT",
        "first_name": "RANDOLPH",
        "middle_name": "N.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000207L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coatesville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.