Individual provider Active NPI

Dewey K Foutz III, PHARMD, PHC

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • San Diego, CA
National Provider Identifier
1053653055
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PC00000258 Issued in NM
Practice address
Naval Medical Center San Diego 34800 Bob Wilson Dr
San Diego, CA 92134-0001
Phone
(619) 532-8400
NPI assigned
Mar 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP000080041 NM
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PC00000258 NM Primary

Addresses

Primary practice location

Naval Medical Center San Diego 34800 Bob Wilson Dr
San Diego, CA 92134-0001

Mailing address

Naval Medical Center San Diego 34800 Bob Wilson Dr
San Diego, CA 92134-0001
Phone (619) 532-8400

Other names 1

  • Trey Foutz Other name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP000080041NMMDPharmacist
PC00000258NMMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1053653055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUTZ",
        "first_name": "DEWEY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARMD, PHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP000080041",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NM",
            "license": "PC00000258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TREY",
            "last_name": "FOUTZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.