Active NPI
Melissa Balizan, PHARM D
- Pharmacist
- Pueblo West, CO
National Provider Identifier
1104204403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15877
- Practice address
- 318 S Nicklaus Dr
Pueblo West, CO 81007-3627 - NPI assigned
- May 7, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 15877 | CO | Primary |
Addresses
Primary practice location
318 S Nicklaus Dr
Pueblo West, CO 81007-3627
Mailing address
1022 Fortino Blvd Unit 9562
Pueblo, CO 81008-2322
Phone (719) 280-2637
Other practice location 1
915 W Northern Ave
Pueblo, CO 81004-3195
Phone (719) 545-1811
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | doc@drmelissabalizan.com | Direct |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15877 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JB Pharmacy Inc | Pharmacist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661644800000",
"number": "1104204403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1022 FORTINO BLVD UNIT 9562",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810082322",
"telephone_number": "719-280-2637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 S NICKLAUS DR",
"city": "PUEBLO WEST",
"state": "CO",
"postal_code": "810073627"
}
],
"practiceLocations": [
{
"address_1": "915 W Northern Ave",
"address_purpose": "LOCATION",
"city": "Pueblo",
"state": "CO",
"postal_code": "810043195",
"country_code": "US",
"telephone_number": "719-545-1811",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALIZAN",
"first_name": "MELISSA",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-07",
"last_updated": "2022-08-28",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "15877",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "doc@drmelissabalizan.com",
"affiliation": "N",
"endpointDescription": "secure network, encrypted email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "318 S Nicklaus Dr",
"city": "Pueblo West",
"state": "CO",
"country_code": "US",
"postal_code": "810073627",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Pueblo West, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.