Individual provider Active NPI

Anita Chang

  • Pharmacist
  • Colorado Springs, CO
National Provider Identifier
1740893387
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA.0024741 Issued in CO
Practice address
15 N Union Blvd
Colorado Springs, CO 80909-5754
Phone
(719) 452-4356
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 39645 TN
Pharmacist 183500000X PHA.0024741 CO Primary

Addresses

Primary practice location

15 N Union Blvd
Colorado Springs, CO 80909-5754

Mailing address

6545 Grey Eagle LN
Colorado Springs, CO 80919-1635

Other practice location 1

795 El Camino Real Ste Ab111A
Palo Alto, CA 94301-2302
Phone (650) 687-0154

Other practice location 2

9028 Walnut Grove Rd
Cordova, TN 38018-7469
Phone (901) 754-3945

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

LicenseStateTypeSpecialty
PHA.0024741COMDPharmacist
39645TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jul 1, 2022 Accepting new patients
Walgreen Co PastSince May 7, 2024 Accepting new patients
Walgreen Co PastSince Aug 1, 2020 Accepting new patients
Walgreen Co PastSince Aug 1, 2020 Accepting new patients

Locations

795 El Camino Real
Ste AB111A
Palo Alto, CA 94301
Phone (650) 687-0154

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1740893387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 GREY EAGLE LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809191635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095754",
            "telephone_number": "719-452-4356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 El Camino Real Ste Ab111A",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943012302",
            "country_code": "US",
            "telephone_number": "650-687-0154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9028 Walnut Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380187469",
            "country_code": "US",
            "telephone_number": "901-754-3945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ANITA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "39645",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0024741",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 1, 2024; 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.