Active NPI
Marietta Wells, RPH
- Pharmacist
- Loveland, CO
National Provider Identifier
1184068272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13137
- Practice address
- 1275 Eagle Dr
Loveland, CO 80537-8058 - Phone
- (970) 663-2048
- Fax
- (970) 223-5844
- NPI assigned
- Apr 19, 2013
- Last updated
- Oct 1, 2020
- 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 | 13137 | CO | Primary |
Addresses
Primary practice location
1275 Eagle Dr
Loveland, CO 80537-8058
Mailing address
4503 JFK Parkway
Fort Collins, CO 80525
Phone (970) 223-5769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03003936 | Medicaid | CO |
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 |
|---|---|---|---|
| 13137 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dillon Companies LLC | Past | Accepting new patients | |
| Dillon Companies LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba King Soopers Pharmacy #153
- Community/Retail Pharmacy
- Fountain, CO
- NPI 1194524165
-
dba King Soopers Pharmacy
- Community/Retail Pharmacy
- Loveland, CO
- NPI 1689619355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1184068272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4503 JFK PARKWAY",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "80525",
"telephone_number": "970-223-5769",
"fax_number": "970-223-5844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 EAGLE DR",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805378058",
"telephone_number": "970-663-2048",
"fax_number": "970-223-5844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "MARIETTA",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-19",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "13137",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03003936",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Loveland, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.