Individual provider Active NPI

Jane Abigail Trujillo, NP

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1396283586
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0992502 Issued in CO
Practice address
2960 N Circle Dr Ste 200
Colorado Springs, CO 80909-1163
Phone
(719) 634-8891
Fax
(719) 634-1897
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0992502 CO Primary

Addresses

Primary practice location

2960 N Circle Dr Ste 200
Colorado Springs, CO 80909-1163

Mailing address

2960 N Circle Dr Ste 200
Colorado Springs, CO 80909-1163

Other names 1

  • Jane Abigail Graham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170717003494 CO Practitioner - Nurse Practitioner 3971888991 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0992502COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Dec 1, 2018 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Dec 1, 2018 Accepting new patients

Locations

1633 Medical Center Pt
Colorado Springs, CO 80907
Phone (719) 636-2999

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1396283586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 N CIRCLE DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 N CIRCLE DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091163",
            "telephone_number": "719-634-8891",
            "fax_number": "719-634-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "JANE",
        "middle_name": "ABIGAIL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0992502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "GRAHAM",
            "middle_name": "ABIGAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.