Individual provider Active NPI

Charlton H Trinidad, MD

  • Internal Medicine Physician
  • Prattville, AL
National Provider Identifier
1366530529
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20890 Issued in AL
Practice address
1739 E Main St
Prattville, AL 36066-5525
Phone
(334) 358-8106
Fax
(334) 358-8107
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20890 AL Primary

Addresses

Primary practice location

1739 E Main St
Prattville, AL 36066-5525

Mailing address

2257 Taylor Rd
Suite 200
Montgomery, AL 36117-7790
Phone (334) 270-9914

Other identifiers 1

IdentifierTypeStateIssuer
51510266OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025000111 AL Practitioner - Internal Medicine 8820112634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prattville Medical Clinic, PCGroup PAC ID 0840217188, 2 clinicians

Practice addresses (Care Compare)

1739 E Main St
Prattville, AL 36066-5525
Phone (334) 358-8106

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prattville Medical Clinic, PC Internal Medicine CurrentSince Oct 21, 2002 Accepting new patients

Locations

2257 Taylor Rd
Ste 200
Montgomery, AL 36117
Phone (334) 270-9914

1739 E Main St
Prattville, AL 36066
Phone (334) 358-8106

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366530529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 TAYLOR RD",
            "address_2": "SUITE 200",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177790",
            "telephone_number": "334-270-9914",
            "fax_number": "334-270-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 E MAIN ST",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665525",
            "telephone_number": "334-358-8106",
            "fax_number": "334-358-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINIDAD",
        "first_name": "CHARLTON",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "20890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51510266",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

Verify at the official NPI Registry.