NPIMap

Individual provider Active NPI

Trinity Vallejo

  • Internal Medicine Physician
  • Garden City, KS
National Provider Identifier
1952833519
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-43172 Issued in KS
Practice address
311 E Spruce St
Garden City, KS 67846-5614
Phone
(620) 275-3710
Fax
(620) 271-3133
NPI assigned
Apr 1, 2017
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 04-43172 KS Primary

Addresses

Primary practice location

311 E Spruce St
Garden City, KS 67846-5614

Mailing address

395 W 12TH Ave
Third Floor
Columbus, OH 43210-1267
Phone (614) 293-3989

Other practice location 1

395 W 12th Ave
Third Floor
Columbus, OH 43210-1267
Phone (614) 293-3989

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
I20201130000279 KS Practitioner - Internal Medicine 4789954058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonspirit Kansas IncGroup PAC ID 4789595844, 62 clinicians
Bob Wilson Memorial Grant County HospitalGroup PAC ID 9436068632, 10 clinicians

Practice addresses (Care Compare)

311 E Spruce St
SCHC Family Practice
Garden City, KS 67846-5614
Phone (620) 275-3780

505 N Main St
Ulysses, KS 67880-2135

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-43172KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Catherine Hospital CurrentSince Dec 1, 2020 Accepting new patients
Commonspirit Kansas, Inc. Current Accepting new patients
Commonspirit Kansas, Inc. Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
St. Catherine Hospital Internal Medicine Past Accepting new patients
Commonspirit Kansas, Inc. Past Accepting new patients
Ranch House Nursing Facility Operations LLC Past Accepting new patients
Garden Valley Retirement Village, LLC Past Accepting new patients
Commonspirit Kansas, Inc. Internal Medicine Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

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

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 8

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 9

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": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1952833519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE",
            "address_2": "THIRD FLOOR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-3989"
        },
        {
            "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": "620-275-3710",
            "fax_number": "620-271-3133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 12th Ave",
            "address_2": "Third Floor",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-293-3989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "TRINITY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-01",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-43172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.