Cailin Petersen

Primary specialty

PharmacistTaxonomy code 183500000X

License

0015573 Issued in CT

Practice address

3 N 2ND Ave
Taftville, CT 06380-1407

Phone

(860) 225-5543

NPI assigned

Jan 4, 2021

Last updated

Jan 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TRCP LLC

  dba dba: Nutmeg Pharmacy

  • Community/Retail Pharmacy
  • Taftville, CT
  • NPI 1639651037
  NPD Authorized official
• TRCP LLC

  • Long Term Care Pharmacy
  • Taftville, CT
  • NPI 1902421050
  NPD Authorized official

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1912595141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 N 2ND AVE",
            "city": "TAFTVILLE",
            "state": "CT",
            "postal_code": "063801407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 N 2ND AVE",
            "city": "TAFTVILLE",
            "state": "CT",
            "postal_code": "063801407",
            "telephone_number": "860-225-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "CAILIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "TCI0008769",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "0015573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassidy Mary Mello, RN
• Vernon Moore, BGA
• Mozden Family Optical LLC
• Alexandria Munoz, ATC
• Jason Navallil
• Joshua T Robinson, ATC/L
• Beverly Anna Strickland, LMT
• Samson Tonton
• TRCP LLC (dba: Nutmeg Pharmacy)
• TRCP LLC

• Pharmacist in Taftville, CT
• Providers in Taftville, CT by specialty
• Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.