Collin Lietz, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

1-110979 Issued in KS

Practice address

9525 E 21St St N
Wichita, KS 67206-2946

Phone

(316) 631-1401

Fax

(316) 631-1403

NPI assigned

Jul 31, 2024

Last updated

Jul 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1083443725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9525 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062946",
            "telephone_number": "316-631-1401",
            "fax_number": "316-631-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062946",
            "telephone_number": "316-631-1401",
            "fax_number": "316-631-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETZ",
        "first_name": "COLLIN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-110979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Wichita, KS
• Providers in Wichita, KS by specialty
• Pharmacist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.