Individual provider Active NPI

Jenna Luitjohan

  • Pharmacist
  • Fort Collins, CO
National Provider Identifier
1205345170
Registry record updated Sep 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0021969 Issued in CO
Practice address
2451 S Timberline Rd Apt 7-207
Fort Collins, CO 80525-4167
Phone
(618) 410-6157
NPI assigned
Sep 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0021969 CO Primary

Addresses

Primary practice location

2451 S Timberline Rd Apt 7-207
Fort Collins, CO 80525-4167

Mailing address

2451 S Timberline Rd Apt 7-207
Fort Collins, CO 80525-4167

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
0021969COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1506124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506124800000",
    "number": "1205345170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 S TIMBERLINE RD APT 7-207",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 S TIMBERLINE RD APT 7-207",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254167",
            "telephone_number": "618-410-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUITJOHAN",
        "first_name": "JENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-23",
        "last_updated": "2017-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0021969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2017; 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.