Active NPI
Derek T Hettinger
- Pharmacist
- Lamar, CO
National Provider Identifier
1548723729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0022329
- Practice address
- 1432 E Olive St
Lamar, CO 81052-2958 - Phone
- (719) 336-0541
- NPI assigned
- Apr 13, 2019
- Last updated
- Apr 13, 2019
- 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 | 0022329 | CO | Primary |
Addresses
Primary practice location
1432 E Olive St
Lamar, CO 81052-2958
Mailing address
1432 E Olive St
Lamar, CO 81052-2958
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 |
|---|---|---|---|
| 0022329 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555113600000",
"number": "1548723729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1432 E OLIVE ST",
"city": "LAMAR",
"state": "CO",
"postal_code": "810522958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1432 E OLIVE ST",
"city": "LAMAR",
"state": "CO",
"postal_code": "810522958",
"telephone_number": "719-336-0541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETTINGER",
"first_name": "DEREK",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-13",
"last_updated": "2019-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "0022329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lamar, CO
- Joshua Hammond, MD
- Emily A Hatcher, APRN
- Sharon K Headrick, MSW
- Michelle Ann Heck, RN, BSN
- Heather Leigh Hernandez
- Pauletta Hickman
- High Plains Community Health Center Incorporated (High Plains Lamar Clinic)
- High Plains Community Health Center Incorporated (Holly High Plains Dispensary)
- High Plains Community Health Center Incorporated (Family Health Center)
- High Plains Community Health Center Incorporated (High Plains Adult Community Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.