Individual provider Active NPI

Kayla A Hetrick, PHARMD

  • Critical Care Pharmacist
  • Cleveland, OH
National Provider Identifier
1750996922
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care PharmacistTaxonomy code 1835C0205X
License
03136303 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 308-4051
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302042655 MI
Critical Care Pharmacist 1835C0205X 5302042655 MI
Critical Care Pharmacist 1835C0205X 03136303 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

10148 Highland Dr
Brecksville, OH 44141-3327

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
5302042655MIMDPharmacist
03136303OHMDCritical Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1750996922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10148 HIGHLAND DR",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-308-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETRICK",
        "first_name": "KAYLA",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302042655",
            "primary": false
        },
        {
            "code": "1835C0205X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Critical Care",
            "state": "MI",
            "license": "5302042655",
            "primary": false
        },
        {
            "code": "1835C0205X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Critical Care",
            "state": "OH",
            "license": "03136303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.