Active NPI
Nathan Brock McConnell
- Pharmacist
- Julesburg, CO
National Provider Identifier
1053655852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19402
- Practice address
- 121 Cedar St
Julesburg, CO 80737-1519 - Phone
- (618) 499-2551
- NPI assigned
- Nov 16, 2012
- Last updated
- Nov 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19402 | CO | Primary |
Addresses
Primary practice location
121 Cedar St
Julesburg, CO 80737-1519
Mailing address
121 Cedar St
Julesburg, CO 80737-1519
Phone (618) 499-2551
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 |
|---|---|---|---|
| 19402 | CO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1053655852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 CEDAR ST",
"city": "JULESBURG",
"state": "CO",
"postal_code": "807371519",
"telephone_number": "618-499-2551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 CEDAR ST",
"city": "JULESBURG",
"state": "CO",
"postal_code": "807371519",
"telephone_number": "618-499-2551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "NATHAN",
"middle_name": "BROCK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-16",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "19402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Julesburg, CO
- Troy Douglas Kinoshita, RN
- Douglas Lee Kruckner, M.D.
- Michael Lipnick, M.D.
- Autumn Marie Martin, MS,FNP
- Natalie Marie Mayer, PA-C
- Northeast Colorado Health Department
- Northeast Colorado Health Department
- Obstetrix Medical Group of Colorado, P.C. (Rocky Mountain Pediatric Cardiology)
- Brenda Lynn Powell
- Donald Dean Regier, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.