Active NPI
Spencer Blake Tebbe
- Pharmacist
- Glendale, CO
National Provider Identifier
1467128579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0023667
- Practice address
- 360 S Colorado Blvd
Glendale, CO 80246-1205 - Phone
- (720) 258-8203
- NPI assigned
- Aug 18, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0023667 | CO | Primary |
Addresses
Primary practice location
360 S Colorado Blvd
Glendale, CO 80246-1205
Mailing address
819 S Downing St
Denver, CO 80209-4435
Phone (317) 966-1849
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rxm.12366@store.walgreens.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0023667 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1467128579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 S DOWNING ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802094435",
"telephone_number": "317-966-1849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 S COLORADO BLVD",
"city": "GLENDALE",
"state": "CO",
"postal_code": "802461205",
"telephone_number": "720-258-8203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEBBE",
"first_name": "SPENCER",
"middle_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-18",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "0023667",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rxm.12366@store.walgreens.com",
"affiliation": "N",
"address_1": "360 S Colorado Blvd",
"city": "Glendale",
"state": "CO",
"country_code": "US",
"postal_code": "802461205",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Glendale, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.