Individual provider Active NPI

Vixen Deines, PHARM.D.

  • Pharmacotherapy Pharmacist
  • Colorado Springs, CO
National Provider Identifier
1780937888
Registry record updated Dec 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
PHA.00022196 Issued in CO
Practice address
6025 Erin Park Dr
Colorado Springs, CO 80918-5400
Phone
(785) 766-8149
NPI assigned
Oct 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X PHA.00022196 CO Primary
Pharmacist 183500000X 2006038102 MO
Pharmacist 183500000X 1-13959 KS

Addresses

Primary practice location

6025 Erin Park Dr
Colorado Springs, CO 80918-5400

Mailing address

6025 Erin Park Dr
Colorado Springs, CO 80918-5400
Phone (785) 766-8149

Other identifiers 1

IdentifierTypeStateIssuer
PHA.0022196OtherCOCOLORADO DEPARTMENT OF REGULATORY AGENCIES DIVISION OF PROFESSIONS & OCCUPATIONS

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
1-13959KSMDPharmacist
2006038102MOMDPharmacist
PHA.00022196COMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Phlourish RX Current Accepting new patients

Locations

6025 Erin Park Dr
Colorado Springs, CO 80918
Phone (720) 505-9709

Organizations & group practices 1

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": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1780937888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 ERIN PARK DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185400",
            "telephone_number": "785-766-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 ERIN PARK DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185400",
            "telephone_number": "785-766-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEINES",
        "first_name": "VIXEN",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CO",
            "license": "PHA.00022196",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2006038102",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-13959",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF REGULATORY AGENCIES DIVISION OF PROFESSIONS & OCCUPATIONS",
            "identifier": "PHA.0022196",
            "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 Dec 21, 2018; 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.