Individual provider Active NPI

Patricia Ann Wright, RPH

  • Pharmacist
  • Johnstown, CO
National Provider Identifier
1477081404
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14128 Issued in CO
Practice address
4770 Larimer Pkwy
Johnstown, CO 80534-8918
Phone
(970) 800-5511
NPI assigned
Jun 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 14128 CO Primary

Addresses

Primary practice location

4770 Larimer Pkwy
Johnstown, CO 80534-8918

Mailing address

4470 Grinnell Ave
Boulder, CO 80305-6613
Phone (303) 499-1052

Other practice location 1

2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3111

Other names 1

  • Miss Patricia Ann Wallace Former name

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
14128COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1496448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1477081404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 GRINNELL AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056613",
            "telephone_number": "303-499-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 LARIMER PKWY",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805348918",
            "telephone_number": "970-800-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043573",
            "country_code": "US",
            "telephone_number": "303-440-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "14128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "WALLACE",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnstown, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.