Individual provider Active NPI

Steven Charles Gillispie, RPH

  • Pharmacist
  • Pueblo, CO
National Provider Identifier
1861760068
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13014 Issued in CO
Practice address
2900 W Northern Ave
Pueblo, CO 81005-2315
Phone
(719) 561-9728
NPI assigned
Dec 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13014 CO Primary
Pharmacotherapy Pharmacist 1835P1200X 013014 CO

Addresses

Primary practice location

2900 W Northern Ave
Pueblo, CO 81005-2315

Mailing address

686 S Bayfield Ave
Pueblo, CO 81007-2798
Phone (719) 547-9165

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13014COMDPharmacist
013014COMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1861760068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 S BAYFIELD AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810072798",
            "telephone_number": "719-547-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W NORTHERN AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052315",
            "telephone_number": "719-561-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLISPIE",
        "first_name": "STEVEN",
        "middle_name": "CHARLES",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "13014",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CO",
            "license": "013014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.