Individual provider Active NPI

Trevor Lee Demass, PHARMD

  • Pharmacist
  • Salt Lake City, UT
National Provider Identifier
1720718562
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6312198-1701 Issued in UT
Practice address
82 S 1100 E Ste 104
Salt Lake City, UT 84102-1687
Phone
(801) 521-6353
Fax
(801) 521-6390
NPI assigned
Jun 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6312198-1701 UT Primary

Addresses

Primary practice location

82 S 1100 E Ste 104
Salt Lake City, UT 84102-1687

Mailing address

82 S 1100 E Ste 104
Salt Lake City, UT 84102-1687
Phone (801) 521-6353

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL apothshoppe@gmail.com Direct

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
6312198-1701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Apothecary Shoppe, Inc PastSince Jun 21, 2022 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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1720718562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 S 1100 E STE 104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021687",
            "telephone_number": "801-521-6353",
            "fax_number": "801-521-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 S 1100 E STE 104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021687",
            "telephone_number": "801-521-6353",
            "fax_number": "801-521-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMASS",
        "first_name": "TREVOR",
        "middle_name": "LEE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "6312198-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "apothshoppe@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "82 S 1100 E Ste 104",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841021687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.