Individual provider Active NPI

Kelsy Sue Trutt, PHARMD

  • Pharmacist
  • Webster, NY
National Provider Identifier
1083384705
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
064344 Issued in NY
Practice address
2186 Empire Blvd
Webster, NY 14580-2000
Phone
(585) 236-4020
Fax
(585) 236-4021
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064344 NY Primary

Addresses

Primary practice location

2186 Empire Blvd
Webster, NY 14580-2000

Mailing address

526 Wildbriar Rd
Rochester, NY 14623-4240
Phone (570) 490-2104

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA

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
064344NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Danwins LLC PastSince Sep 23, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1083384705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 WILDBRIAR RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234240",
            "telephone_number": "570-490-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 EMPIRE BLVD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145802000",
            "telephone_number": "585-236-4020",
            "fax_number": "585-236-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUTT",
        "first_name": "KELSY",
        "middle_name": "SUE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "2186 Empire Blvd",
            "city": "Webster",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145802000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.