Active NPI
Sharon J. Roberts, PHARMD
- Pharmacist
- Colorado Springs, CO
National Provider Identifier
1619957461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19254
- Practice address
- 5050 N Nevada Ave
Attn: Costco Pharmacy
Colorado Springs, CO 80918-8602 - Phone
- (719) 264-5019
- Fax
- (719) 264-5016
- NPI assigned
- Jan 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202012857 | VA | |
| Pharmacist | 183500000X | 19254 | GA | Primary |
Addresses
Primary practice location
5050 N Nevada Ave
Attn: Costco Pharmacy
Colorado Springs, CO 80918-8602
Mailing address
5050 N Nevada Ave
Attn: Costco Pharmacy
Colorado Springs, CO 80918-8602
Phone (719) 264-5019
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0202012857 | Other | VA | VA RPH LICENSE |
| 19254 | Other | GA | GA RPH LICENSE |
| PS45771 | Other | FL | FLORIDA BOARD OF PHARMACY |
| PHA.0020325 | Other | CO | COLORADO BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 19254 | GA | MD | Pharmacist |
| 0202012857 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1619957461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 N NEVADA AVE",
"address_2": "ATTN: COSTCO PHARMACY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809188602",
"telephone_number": "719-264-5019",
"fax_number": "719-264-5016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 N NEVADA AVE",
"address_2": "ATTN: COSTCO PHARMACY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809188602",
"telephone_number": "719-264-5019",
"fax_number": "719-264-5016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "SHARON",
"middle_name": "J.",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202012857",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "19254",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA RPH LICENSE",
"identifier": "0202012857",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA RPH LICENSE",
"identifier": "19254",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BOARD OF PHARMACY",
"identifier": "PS45771",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORADO BOARD OF PHARMACY",
"identifier": "PHA.0020325",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.