Active NPI
Marcia H Trujillo, LMT
- Massage Therapist
- Clovis, NM
National Provider Identifier
1245362607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 5327
- Practice address
- 2905 N Prince St Ste C
Clovis, NM 88101-3843 - Phone
- (505) 714-4395
- NPI assigned
- Mar 12, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 5327 | NM | Primary |
Addresses
Primary practice location
2905 N Prince St Ste C
Clovis, NM 88101-3843
Mailing address
1629 S Avenue C
Portales, NM 88130-7207
Phone (505) 226-0045
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00RE88 | Other | NM | BLUE CROSS BLUE SHIELD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5327 | NM | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245362607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1629 S AVENUE C",
"city": "PORTALES",
"state": "NM",
"postal_code": "881307207",
"telephone_number": "505-226-0045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 N PRINCE ST STE C",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881013843",
"telephone_number": "505-714-4395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUJILLO",
"first_name": "MARCIA",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "5327",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00RE88",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.