Christian Trujillo, MD
Individual provider Active NPI Pulmonary Disease Physician · Thomasville, GA
NPI 1710408554 · NPPES record last updated Jul 13, 2023
Key facts
- NPI
- 1710408554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 94182 (GA)
- Practice address
- 2705 E Pinetree Blvd Ste C
Thomasville, GA 31792-4875 - Phone
- (229) 584-5731
- NPI assigned
- Jul 1, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Critical Care (Intensivists)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Archbold Medical Group, Inc.
Practice addresses (Care Compare)
2705 E Pinetree Blvd
Suite C
Thomasville, GA 31792-4875
Phone (229) 584-5731
Hospital & facility affiliations
- Archbold Home Health Services
- Archbold Memorial Hospital
- Grady General Hospital
- Memorial Hospital and Manor
- Archbold Brooks
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230829001318 | GA | Practitioner - Critical Care (Intensivists) | 5890069256 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94182 | GA | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Archbold Medical Group, Inc. | Pulmonary Disease | Current |
Accepting new patients |
| Pathology Associates, P.C. | Current | Accepting new patients | |
| John D Archbold Memorial Hospital Inc | Current |
Accepting new patients | |
| Archbold Medical Group | Internal Medicine | Current |
Accepting new patients |
| Archbold Medical Group, Inc. | Current | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
1309 W Screven St
Quitman, GA 31643
Phone (229) 227-5158
920 Cairo Rd
Thomasville, GA 31792
Phone (229) 228-8800
900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102
2705 E Pinetree Blvd
Ste C
Thomasville, GA 31792
Phone (229) 228-7008
100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141
915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 94182 | GA | Yes |
| Internal Medicine Physician | 207R00000X | 125070145 | IL | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 94182 | GA |
Addresses
Primary practice location
2705 E Pinetree Blvd Ste C
Thomasville, GA 31792-4875
Mailing address
313 Madison Grove Blvd
Thomasville, GA 31757-3922
Phone (872) 210-7510
Other practice location 1
1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 864-6000
Other providers in Thomasville, GA
- Total Renal Care Inc.
- Shawnee M Trejo
- Lauren Trevino
- Trio Therapy Services, Inc
- Philip D Troyer
- Trumarx Drugs Inc
- Truth Is Therapy & More, LLC
- Madison Nicole Tuch
- Jackson Seth Tucker
- Kate Courtney Tucker
All providers in Thomasville, GA · Pulmonary Disease Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.