Individual provider Active NPI

Michael Crookston, PHARMD

  • Pharmacist
  • Fort Collins, CO
National Provider Identifier
1932471703
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA.0019701 Issued in CO
Practice address
2190 W Drake Rd
Fort Collins, CO 80526-1488
Phone
(970) 484-5841
Fax
(970) 484-6913
NPI assigned
Feb 8, 2012
Sex
Male
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
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PHA.0019701 CO Primary

Addresses

Primary practice location

2190 W Drake Rd
Fort Collins, CO 80526-1488

Mailing address

2724 Michener Dr
Fort Collins, CO 80526-6237

Other practice location 1

4891 Alberta Falls Way
Colorado Springs, CO 80924-1208
Phone (719) 659-4854

Other practice location 2

2600 11th Ave
Greeley, CO 80631-8441
Phone (970) 475-0554

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
PHA.0019701COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1932471703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 MICHENER DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 W DRAKE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261488",
            "telephone_number": "970-484-5841",
            "fax_number": "970-484-6913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4891 Alberta Falls Way",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809241208",
            "country_code": "US",
            "telephone_number": "719-659-4854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806318441",
            "country_code": "US",
            "telephone_number": "970-475-0554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROOKSTON",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0019701",
            "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 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.