Active NPI
Bryan-Lee Austin Trent
- Pharmacist
- South Williamson, KY
National Provider Identifier
1306412697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I15347
- Practice address
- 28402 US Highway 119
South Williamson, KY 41503-3924 - Phone
- (606) 237-4443
- NPI assigned
- May 27, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | I15347 | KY | Primary |
Addresses
Primary practice location
28402 US Highway 119
South Williamson, KY 41503-3924
Mailing address
78 Cluster Dr
Wharncliffe, WV 25651-7231
Phone (304) 664-8070
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
| License | State | Type | Specialty |
|---|---|---|---|
| I15347 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1306412697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 CLUSTER DR",
"city": "WHARNCLIFFE",
"state": "WV",
"postal_code": "256517231",
"telephone_number": "304-664-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28402 US HIGHWAY 119",
"city": "SOUTH WILLIAMSON",
"state": "KY",
"postal_code": "415033924",
"telephone_number": "606-237-4443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRENT",
"first_name": "BRYAN-LEE",
"middle_name": "AUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "I15347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Williamson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.