Active NPI
Rodger Paul Wilson, RPH
- Pharmacist
- Longmont, CO
National Provider Identifier
1114158805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1996
- Practice address
- 1138 Wyndemere Cir
Longmont, CO 80501-2322 - Phone
- (303) 579-1100
- Fax
- (303) 702-9133
- NPI assigned
- Jul 29, 2009
- Sex
- Male
- 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 | 1996 | WY | Primary |
Addresses
Primary practice location
1138 Wyndemere Cir
Longmont, CO 80501-2322
Mailing address
1138 Wyndemere Cir
Longmont, CO 80501-2322
Phone (303) 579-1100
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1996 | WY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248825600000",
"number": "1114158805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1138 WYNDEMERE CIR",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805012322",
"telephone_number": "303-579-1100",
"fax_number": "303-702-9133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1138 WYNDEMERE CIR",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805012322",
"telephone_number": "303-579-1100",
"fax_number": "303-702-9133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "RODGER",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-29",
"last_updated": "2009-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "1996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.