Individual provider Active NPI

Roberto Jaime Trujillo, AGACNP-BC

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1841887502
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1020434 Issued in TX
Practice address
11130 Christus HLS Ste 207
San Antonio, TX 78251-3586
Phone
(210) 228-0044
Fax
(210) 228-0045
NPI assigned
Dec 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 1020434 TX Primary

Addresses

Primary practice location

11130 Christus HLS Ste 207
San Antonio, TX 78251-3586

Mailing address

11130 Christus HLS Ste 207
San Antonio, TX 78251-3586
Phone (210) 228-0044

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)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1841887502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HLS STE 207",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513586",
            "telephone_number": "210-228-0044",
            "fax_number": "210-228-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HLS STE 207",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513586",
            "telephone_number": "210-228-0044",
            "fax_number": "210-228-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "ROBERTO",
        "middle_name": "JAIME",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1020434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.