Active NPI
Kristin G Staab, RPH
- Pharmacist
- Colorado Springs, CO
National Provider Identifier
1629378146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14480
- Practice address
- 2785 Dublin Blvd
Colorado Springs, CO 80918-1360 - Phone
- (719) 593-8940
- Fax
- (719) 598-3918
- NPI assigned
- Oct 31, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14480 | CO | Primary |
Addresses
Primary practice location
2785 Dublin Blvd
Colorado Springs, CO 80918-1360
Mailing address
3824 Bell Mountain Dr
Castle Rock, CO 80104-7710
Phone (720) 839-1954
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000171948 | Medicaid | CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14480 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1629378146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3824 BELL MOUNTAIN DR",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801047710",
"telephone_number": "720-839-1954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2785 DUBLIN BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809181360",
"telephone_number": "719-593-8940",
"fax_number": "719-598-3918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAAB",
"first_name": "KRISTIN",
"middle_name": "G",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-31",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "14480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000171948",
"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 Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.