Individual provider Active NPI

Bryan Douglas Killam, PHARMD

  • Pharmacist
  • Thornton, CO
National Provider Identifier
1316285380
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16265 Issued in CO
Practice address
2801 E 120TH Ave
Apt E208
Thornton, CO 80233-1499
Phone
(720) 291-2529
NPI assigned
Jan 24, 2013
Last updated
Jan 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16265 CO Primary

Addresses

Primary practice location

2801 E 120TH Ave
Apt E208
Thornton, CO 80233-1499

Mailing address

2801 E 120TH Ave
Apt E208
Thornton, CO 80233-1499
Phone (720) 291-2529

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
16265COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1316285380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 E 120TH AVE",
            "address_2": "APT E208",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802331499",
            "telephone_number": "720-291-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 E 120TH AVE",
            "address_2": "APT E208",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802331499",
            "telephone_number": "720-291-2529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLAM",
        "first_name": "BRYAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "16265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.