Active NPI
Trevor Durrant Judd
- Pharmacist
- Evanston, WY
National Provider Identifier
1962287706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4484
- Practice address
- 70 Yellow Creek Rd
Evanston, WY 82930-5227 - Phone
- (307) 789-0535
- NPI assigned
- Aug 29, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11338036-1701 | UT | |
| Pharmacist | 183500000X | 4484 | WY | Primary |
Addresses
Primary practice location
70 Yellow Creek Rd
Evanston, WY 82930-5227
Mailing address
811 S 200 E
Farmington, UT 84025-2102
Phone (801) 660-9623
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 |
|---|---|---|---|
| 11338036-1701 | UT | MD | Pharmacist |
| 4484 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smiths Food & Drug Centers Inc | Current | Accepting new patients | |
| Smith'S Food & Drug Centers Inc | Past | Accepting new patients |
Locations
70 Yellow Creek Rd
Evanston, WY 82930
Phone (307) 789-0535
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Evanston, WY
- NPI 1659396281
-
- Community/Retail Pharmacy
- Henderson, NV
- NPI 1881585248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1962287706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 S 200 E",
"city": "FARMINGTON",
"state": "UT",
"postal_code": "840252102",
"telephone_number": "801-660-9623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 YELLOW CREEK RD",
"city": "EVANSTON",
"state": "WY",
"postal_code": "829305227",
"telephone_number": "307-789-0535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDD",
"first_name": "TREVOR",
"middle_name": "DURRANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-29",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "11338036-1701",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "4484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.