Active NPI
Wyvolyn Craig
- Pharmacist
- Colorado Springs, CO
National Provider Identifier
1073143590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHA.0024188
- Practice address
- 1920 S Chelton Rd
Colorado Springs, CO 80916-5304 - Phone
- (719) 570-1618
- NPI assigned
- Jan 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | S12709 | AL | |
| Pharmacist | 183500000X | PHA.0024188 | CO | Primary |
Addresses
Primary practice location
1920 S Chelton Rd
Colorado Springs, CO 80916-5304
Mailing address
1920 S Chelton Rd
Colorado Springs, CO 80916-5304
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 |
|---|---|---|---|
| PHA.0024188 | CO | MD | Pharmacist |
| S12709 | AL | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662336000000",
"number": "1073143590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 S CHELTON RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809165304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 S CHELTON RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809165304",
"telephone_number": "719-570-1618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "WYVOLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-23",
"last_updated": "2022-09-05",
"certification_date": "2022-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AL",
"license": "S12709",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA.0024188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.