NPIMap

Individual provider Active NPI

Todd Grossman

  • Pharmacist
  • Woodland Park, CO
National Provider Identifier
1376006502
Registry record updated Apr 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0020716 Issued in CO
Practice address
19600 E US Highway 24
Woodland Park, CO 80863-8758
Phone
(719) 687-4308
Fax
(719) 687-6895
NPI assigned
Apr 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0020716 CO Primary

Addresses

Primary practice location

19600 E US Highway 24
Woodland Park, CO 80863-8758

Mailing address

19600 E US Highway 24
Woodland Park, CO 80863-8758
Phone (719) 687-4308

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
0020716COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. Past Accepting new patients
Walmart Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555200000000",
    "number": "1376006502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19600 E US HIGHWAY 24",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638758",
            "telephone_number": "719-687-4308",
            "fax_number": "719-687-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E US HIGHWAY 24",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638758",
            "telephone_number": "719-687-4308",
            "fax_number": "719-687-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "TODD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2019-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0020716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2019; 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.