Kenneth Breaux Segreto, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

033-0003660 Issued in VT

Practice address

141 Hannaford SQ # 2
Bennington, VT 05201-1653

Phone

(802) 442-3642

Fax

(802) 442-3065

NPI assigned

Apr 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1265757223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 HANNAFORD SQ # 2",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011653",
            "telephone_number": "802-442-3642",
            "fax_number": "802-442-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 HANNAFORD SQ # 2",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011653",
            "telephone_number": "802-442-3642",
            "fax_number": "802-442-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGRETO",
        "first_name": "KENNETH",
        "middle_name": "BREAUX",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-02",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033-0003660",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "54252",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183500000X",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183500000X",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Bennington, VT
• Providers in Bennington, VT by specialty
• Pharmacist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.