Individual provider Active NPI

Tami Anne Colegrove, PHARMD

  • Pharmacist
  • Lorain, OH
National Provider Identifier
1750715124
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03233291 Issued in OH
Practice address
2730 Broadway
Lorain, OH 44052-4836
Phone
(440) 244-0593
Fax
(440) 244-0597
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03233291 OH Primary

Addresses

Primary practice location

2730 Broadway
Lorain, OH 44052-4836

Mailing address

2730 Broadway
Lorain, OH 44052-4836
Phone (440) 244-0593

Other names 1

  • Tami Anne Fletcher Former name

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

LicenseStateTypeSpecialty
03233291OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 6, 2022 Accepting new patients
Walgreen Co PastSince Jun 21, 2020 Accepting new patients

Locations

2730 Broadway
Lorain, OH 44052
Phone (440) 244-0593

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1750715124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524836",
            "telephone_number": "440-244-0593",
            "fax_number": "440-244-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524836",
            "telephone_number": "440-244-0593",
            "fax_number": "440-244-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEGROVE",
        "first_name": "TAMI",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03233291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMI",
            "last_name": "FLETCHER",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.

Verify at the official NPI Registry.