Active NPI
Jordan Trusty
- Pharmacy Technician
- Lafayette, IN
National Provider Identifier
1578121125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 67021924A
- Practice address
- 5165 McCarty LN
Lafayette, IN 47905-8764 - Phone
- (765) 414-7662
- NPI assigned
- May 30, 2019
- Last updated
- Oct 14, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 67021924A | IN | Primary |
Addresses
Primary practice location
5165 McCarty LN
Lafayette, IN 47905-8764
Mailing address
5165 McCarty LN
Lafayette, IN 47905-8764
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 |
|---|---|---|---|
| 67021924A | IN | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1578121125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5165 MCCARTY LN",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479058764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5165 MCCARTY LN",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479058764",
"telephone_number": "765-414-7662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUSTY",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-30",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IN",
"license": "67021924A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.