Individual provider Active NPI

Carolyn Elyce Trout

  • Pharmacist
  • Springfield, IL
National Provider Identifier
1518635366
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.304261 Issued in IL
Practice address
3216 E Clear Lake Ave
Springfield, IL 62702-6208
Phone
(217) 544-7948
NPI assigned
Sep 4, 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 051.304261 IL Primary

Addresses

Primary practice location

3216 E Clear Lake Ave
Springfield, IL 62702-6208

Mailing address

3216 E Clear Lake Ave
Springfield, IL 62702-6208

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
051.304261ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1518635366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 E CLEAR LAKE AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 E CLEAR LAKE AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026208",
            "telephone_number": "217-544-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUT",
        "first_name": "CAROLYN",
        "middle_name": "ELYCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-04",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.304261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

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.