Individual provider Active NPI

Ann M Trujillo, OTA

  • Occupational Therapist
  • Provo, UT
National Provider Identifier
1417690371
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11157546-4202 Issued in UT
Practice address
280 W 940 N
Provo, UT 84604-3394
Phone
(801) 374-4800
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 11157546-4202 UT
Occupational Therapist 225X00000X 11157546-4202 UT Primary

Addresses

Primary practice location

280 W 940 N
Provo, UT 84604-3394

Mailing address

280 W 940 N
Provo, UT 84604-3394
Phone (801) 374-4800

Other names 1

  • Ann M Erwin Former name

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

LicenseStateTypeSpecialty
11157546-4202UTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1417690371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043394",
            "telephone_number": "801-374-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043394",
            "telephone_number": "801-374-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "UT",
            "license": "11157546-4202",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "11157546-4202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "ERWIN",
            "middle_name": "M",
            "credential": "NONE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.