Individual provider Active NPI

Clancey Phillips

  • Pharmacist
  • Denver, CO
National Provider Identifier
1265035315
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA.00023017 Issued in CO
Practice address
7777 E Hampden Ave
Denver, CO 80231-4806
Phone
(303) 481-2822
Fax
(303) 481-2832
NPI assigned
Nov 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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.00023017 CO Primary

Addresses

Primary practice location

7777 E Hampden Ave
Denver, CO 80231-4806

Mailing address

507 S Broadway Ave
Salem, IL 62881-2208
Phone (618) 339-8389

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.00023017COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1265035315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S BROADWAY AVE",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628812208",
            "telephone_number": "618-339-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 E HAMPDEN AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802314806",
            "telephone_number": "303-481-2822",
            "fax_number": "303-481-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CLANCEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.00023017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.