Individual provider Active NPI

Kaitlyn Pouliot

  • Pharmacist
  • Providence, RI
National Provider Identifier
1063016335
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH05873 Issued in RI
Practice address
117 Chapman St Ste 200
Providence, RI 02905-5400
Phone
(401) 444-9909
NPI assigned
Nov 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH05873 RI Primary

Addresses

Primary practice location

117 Chapman St Ste 200
Providence, RI 02905-5400

Mailing address

117 Chapman St Ste 200
Providence, RI 02905-5400
Phone (401) 444-9909

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

State licenses

LicenseStateTypeSpecialty
RPH05873RIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1063016335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CHAPMAN ST STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055400",
            "telephone_number": "401-444-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CHAPMAN ST STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055400",
            "telephone_number": "401-444-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIOT",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-26",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "RPH05873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.