Individual provider Active NPI

Shana Wilcoxson

  • Pharmacist
  • Colorado Springs, CO
National Provider Identifier
1104495498
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA.0023495 Issued in CO
Practice address
7390 Rangewood Dr
Colorado Springs, CO 80918-7701
Phone
(719) 219-1471
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHA.0023495 CO Primary

Addresses

Primary practice location

7390 Rangewood Dr
Colorado Springs, CO 80918-7701

Mailing address

7390 Rangewood Dr
Colorado Springs, CO 80918-7701

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

LicenseStateTypeSpecialty
PHA.0023495COMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1104495498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7390 RANGEWOOD DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809187701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7390 RANGEWOOD DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809187701",
            "telephone_number": "719-219-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOXSON",
        "first_name": "SHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0023495",
            "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 Jun 21, 2021; 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.