Individual provider Active NPI

Lisa Witzke, DOCTOR OF PHARMACY

  • Pharmacist
  • Longmont, CO
National Provider Identifier
1124415500
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19663 Issued in CO
Practice address
2148 Sherman St
Longmont, CO 80501
Phone
(720) 217-5506
NPI assigned
Apr 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19663 CO Primary

Addresses

Primary practice location

2148 Sherman St
Longmont, CO 80501

Mailing address

2148 Sherman St
Longmont, CO 80501-1330
Phone (720) 217-5506

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
19663COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1124415500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2148 SHERMAN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011330",
            "telephone_number": "720-217-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 SHERMAN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "720-217-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITZKE",
        "first_name": "LISA",
        "credential": "DOCTOR OF PHARMACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "19663",
            "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 Apr 23, 2015; 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.