Active NPI
Corey James Colombino, PHARMD
- Pharmacist
- Henderson, NV
National Provider Identifier
1396236089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19887
- Practice address
- 3411 Saint Rose Pkwy
Henderson, NV 89052-4570 - Phone
- (702) 803-7054
- Fax
- (702) 803-7045
- NPI assigned
- May 29, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | IN04221 | NV | |
| Pharmacist | 183500000X | 19887 | NV | Primary |
Addresses
Primary practice location
3411 Saint Rose Pkwy
Henderson, NV 89052-4570
Mailing address
6884 Stonetrace St
Las Vegas, NV 89148-5095
Phone (858) 722-7597
Other practice location 1
791 Marks St
Henderson, NV 89014-8601
Phone (702) 352-2030
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19887 | NV | MD | Pharmacist |
| IN04221 | NV | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1396236089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6884 STONETRACE ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891485095",
"telephone_number": "858-722-7597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3411 SAINT ROSE PKWY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890524570",
"telephone_number": "702-803-7054",
"fax_number": "702-803-7045"
}
],
"practiceLocations": [
{
"address_1": "791 Marks St",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NV",
"postal_code": "890148601",
"country_code": "US",
"telephone_number": "702-352-2030",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLOMBINO",
"first_name": "COREY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-29",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NV",
"license": "IN04221",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "19887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.