Individual provider Active NPI

Kimberly Shirl Trujillo, PT

  • Physical Therapist
  • Fayetteville, NC
National Provider Identifier
1396787750
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9548 Issued in NC
Practice address
3013C Raeford Rd
Fayetteville, NC 28303-5441
Phone
(910) 484-9663
Fax
(910) 484-6668
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9548 NC Primary

Addresses

Primary practice location

3013C Raeford Rd
Fayetteville, NC 28303-5441

Mailing address

4534 Raeford Rd
Fayetteville, NC 28304-3230
Phone (910) 425-5999

Other identifiers 3

IdentifierTypeStateIssuer
9548OtherNCLICENSE NO
079CFOtherNCBCBS PROVIDER ID
7301894MedicaidNC

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
9548NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sports and Orthopedic Therapy Services LLC Physical Therapist Past Accepting new patients
Carolina Complete Rehab Center of Hope Mills Inc Physical Therapist Past Accepting new patients
Bodies in Motion Physical Therapy, LLC Physical Therapist PastSince Aug 10, 2006 Accepting new patients
Activcare Physical Therapy, LLC Physical Therapist PastSince Jan 18, 2016 Accepting new patients
Robert C Grossman & Assoc PA Physical Therapist Past Accepting new patients

Organizations & group practices 5

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396787750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4534 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043230",
            "telephone_number": "910-425-5999",
            "fax_number": "910-425-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3013C RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035441",
            "telephone_number": "910-484-9663",
            "fax_number": "910-484-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "KIMBERLY",
        "middle_name": "SHIRL",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO",
            "identifier": "9548",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "079CF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301894",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.