NPIMap

Individual provider Active NPI

Tina Sue Trujillo, APRN

  • Nurse Practitioner
  • Garden City, KS
National Provider Identifier
1871021436
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-77873 Issued in KS
Practice address
311 E Spruce St
Garden City, KS 67846-5614
Phone
(620) 275-3035
Fax
(620) 275-3756
NPI assigned
May 26, 2017
Last updated
Sep 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-77873 KS Primary

Addresses

Primary practice location

311 E Spruce St
Garden City, KS 67846-5614

Mailing address

401 E Spruce St
Garden City, KS 67846-5679
Phone (620) 272-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170927000340 KS Practitioner - Nurse Practitioner 7113291378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonspirit Kansas IncGroup PAC ID 4789595844, 62 clinicians

Practice addresses (Care Compare)

100 W Ross Blvd
Suite 1B
Dodge City, KS 67801-7217
Phone (620) 371-5576

311 E Spruce St
Garden City, KS 67846-5614

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-77873KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commonspirit Kansas, Inc. CurrentSince Sep 15, 2017 Accepting new patients
St Catherine Hospital CurrentSince Sep 15, 2017 Accepting new patients
Commonspirit Kansas, Inc. Current Accepting new patients
St. Catherine Hospital Past Accepting new patients
Commonspirit Kansas, Inc. Past Accepting new patients
Commonspirit Kansas, Inc. Past Accepting new patients
Commonspirit Kansas, Inc. Past Accepting new patients

Locations

100 W Ross Blvd
Ste 1B
Dodge City, KS 67801
Phone (620) 371-5576

310 E Walnut St
Ste 201
Garden City, KS 67846
Phone (620) 272-2700

311 E Spruce St
Garden City, KS 67846
Phone (620) 271-3139

401 E Spruce St
Garden City, KS 67846
Phone (620) 272-2222

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1871021436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E SPRUCE ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465679",
            "telephone_number": "620-272-2222",
            "fax_number": "620-275-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E SPRUCE ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465614",
            "telephone_number": "620-275-3035",
            "fax_number": "620-275-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "TINA",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-77873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.