Active NPI
Isaac S Trujillo Jr., ATC
- Athletic Trainer
- College Park, MD
National Provider Identifier
1245536358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 468
- Practice address
- 379 Field House Dr
College Park, MD 20742-0001 - Phone
- (240) 417-0111
- NPI assigned
- Feb 7, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 468 | NM | Primary |
Addresses
Primary practice location
379 Field House Dr
College Park, MD 20742-0001
Mailing address
3316 Manorwood Dr
Hyattsville, MD 20782-3164
Phone (505) 573-2293
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 |
|---|---|---|---|
| 468 | NM | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297036800000",
"number": "1245536358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3316 MANORWOOD DR",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207823164",
"telephone_number": "505-573-2293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "379 FIELD HOUSE DR",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207420001",
"telephone_number": "240-417-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUJILLO",
"first_name": "ISAAC",
"middle_name": "S",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-07",
"last_updated": "2011-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NM",
"license": "468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.