Individual provider Active NPI

Thomas Paul Gierwatoski, R.PH.

  • Pharmacist
  • Brighton, CO
National Provider Identifier
1962077966
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15786 Issued in CO
Practice address
1610 Prairie Center Pkwy Ste 2110
Brighton, CO 80601-4001
Phone
(970) 640-7698
NPI assigned
May 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15786 CO Primary

Addresses

Primary practice location

1610 Prairie Center Pkwy Ste 2110
Brighton, CO 80601-4001

Mailing address

1610 Prairie Center Pkwy Ste 2110
Brighton, CO 80601-4001
Phone (970) 640-7698

Other identifiers 1

IdentifierTypeStateIssuer
36776858MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.plattevalleypharmacy.com

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
15786COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medizine Man Inc. CurrentSince May 25, 2021 Accepting new patients
Bennett Family Pharmacy Inc Current Accepting new patients
Medizine Man Inc. PastSince May 25, 2021 Accepting new patients

Organizations & group practices 3

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1962077966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 PRAIRIE CENTER PKWY STE 2110",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014001",
            "telephone_number": "970-640-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 PRAIRIE CENTER PKWY STE 2110",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014001",
            "telephone_number": "970-640-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIERWATOSKI",
        "first_name": "THOMAS",
        "middle_name": "PAUL",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "15786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36776858",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.plattevalleypharmacy.com",
            "affiliation": "N",
            "address_1": "1610 Prairie Center Pkwy Ste 2110",
            "city": "Brighton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "806014001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.

Verify at the official NPI Registry.