Colleen Renae Leadbetter, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

3671 Issued in MT

Practice address

4711 Scott Allen Dr
Missoula, MT 59803-2784

Phone

(406) 728-8848

Fax

(406) 728-4290

NPI assigned

Nov 27, 2006

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 22, 2020.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1013083716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 SCOTT ALLEN DRIVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598032784",
            "telephone_number": "406-728-8848",
            "fax_number": "406-728-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 SCOTT ALLEN DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598032784",
            "telephone_number": "406-728-8848",
            "fax_number": "406-728-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADBETTER",
        "first_name": "COLLEEN",
        "middle_name": "RENAE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "20252",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "3671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Missoula, MT
• Pharmacist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.