Active NPI
Lisa Anne Mandeville, PHARMD RPH
- Pharmacist
- Brighton, CO
National Provider Identifier
1386160885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19451
- Practice address
- 60 W Bromley LN
Brighton, CO 80601-3026 - Phone
- (303) 659-2510
- NPI assigned
- Aug 16, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 19451 | CO | Primary |
Addresses
Primary practice location
60 W Bromley LN
Brighton, CO 80601-3026
Mailing address
60 W Bromley LN
Brighton, CO 80601-3026
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19451 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502841600000",
"number": "1386160885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 W BROMLEY LN",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806013026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 W BROMLEY LN",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806013026",
"telephone_number": "303-659-2510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDEVILLE",
"first_name": "LISA",
"middle_name": "ANNE",
"credential": "PHARMD RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-16",
"last_updated": "2017-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CO",
"license": "19451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.