Individual provider Active NPI

Matthew Hattendorf, PHARMD

  • Pharmacist
  • Denver, CO
National Provider Identifier
1477929362
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0020896 Issued in CO
Practice address
2975 Federal Blvd
Denver, CO 80211-3741
Phone
(303) 433-8911
Fax
(303) 433-8697
NPI assigned
Aug 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0020896 CO Primary

Addresses

Primary practice location

2975 Federal Blvd
Denver, CO 80211-3741

Mailing address

2975 Federal Blvd
Denver, CO 80211-3741
Phone (303) 433-8911

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

LicenseStateTypeSpecialty
0020896COMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1477929362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 FEDERAL BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802113741",
            "telephone_number": "303-433-8911",
            "fax_number": "303-433-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 FEDERAL BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802113741",
            "telephone_number": "303-433-8911",
            "fax_number": "303-433-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTENDORF",
        "first_name": "MATTHEW",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0020896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.