NPIMap

Organization Active NPI

Jaime E Trujillo MD PA

  • Internal Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1730301037
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JAIME E TRUJILLO MD PA
Practice address
3080 Trenwest Drive
Winston Salem, NC 27103
Phone
(336) 768-0496
Fax
(336) 768-0498
NPI assigned
May 3, 2007
Last updated
Nov 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Authorized official

Name
Dr. Jaime E Trujill0, MD
Title
President
Phone
(336) 768-0496

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU

Addresses

Primary practice location

3080 Trenwest Drive
Winston Salem, NC 27103

Mailing address

3080 Trenwest Drive
Winston Salem, NC 27103
Phone (336) 768-0496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000491 NC Part B Supplier - Clinic/Group Practice 3072416049 Receives reassigned benefits from 8 practitioners
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Locations

2928 Maplewood Ave
Ste 102
Winston Salem, NC 27103
Phone (336) 768-0496

3080 Trenwest Dr
Winston Salem, NC 27103
Phone (336) 768-0496

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1730301037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 TRENWEST DRIVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-768-0496",
            "fax_number": "336-768-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 TRENWEST DRIVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-768-0496",
            "fax_number": "336-768-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAIME E TRUJILLO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "TRUJILL0",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-768-0496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.