Active NPI
Tracy Mitchell, PHARMD
- Pharmacist
- Fort Collins, CO
National Provider Identifier
1780083089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17174
- Practice address
- 4502 S College Ave
Fort Collins, CO 80525-3025 - Phone
- (970) 377-0300
- NPI assigned
- Aug 22, 2014
- 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 | 17174 | CO | Primary |
Addresses
Primary practice location
4502 S College Ave
Fort Collins, CO 80525-3025
Mailing address
1605 County Line Rd Apt B211
Longmont, CO 80504-8538
Phone (303) 725-1177
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 |
|---|---|---|---|
| 17174 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1780083089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 COUNTY LINE RD APT B211",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805048538",
"telephone_number": "303-725-1177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 S COLLEGE AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253025",
"telephone_number": "970-377-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "TRACY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-22",
"last_updated": "2021-04-06",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "17174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.