Active NPI
Anita Chang
- Pharmacist
- Colorado Springs, CO
National Provider Identifier
1740893387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHA.0024741
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| PHA.0024741 | CO | MD | Pharmacist |
| 39645 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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.
-
dba Walgreens Specialty Pharmacy #16531
- Community/Retail Pharmacy
- Colorado Springs, CO
- NPI 1023569589
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.