Individual provider Active NPI

Trina Faith Quia-Ong Tagamolila

  • Student in an Organized Health Care Education/Training Program
  • South Bend, IN
National Provider Identifier
1770465569
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4000 Braemore Ave Apt 1106
South Bend, IN 46637-5730
Phone
(219) 315-4161
NPI assigned
Jul 23, 2025
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

4000 Braemore Ave Apt 1106
South Bend, IN 46637-5730

Mailing address

4000 Braemore Ave Apt 1106
South Bend, IN 46637-5730
Phone (219) 315-4161

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

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1770465569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 BRAEMORE AVE APT 1106",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466375730",
            "telephone_number": "219-315-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BRAEMORE AVE APT 1106",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466375730",
            "telephone_number": "219-315-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGAMOLILA",
        "first_name": "TRINA FAITH",
        "middle_name": "QUIA-ONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.