Individual provider Active NPI

Michael Brace, PHARMD

  • Pharmacist
  • Longmont, CO
National Provider Identifier
1962210617
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA.0025055 Issued in CO
Practice address
205 E Ken Pratt Blvd
Longmont, CO 80501-8500
Phone
(303) 827-2534
NPI assigned
Dec 27, 2024
Last updated
Dec 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHA.0025055 CO Primary

Addresses

Primary practice location

205 E Ken Pratt Blvd
Longmont, CO 80501-8500

Mailing address

12565 Eudora St
Thornton, CO 80241-3043
Phone (970) 946-5090

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.0025055COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1962210617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12565 EUDORA ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802413043",
            "telephone_number": "970-946-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E KEN PRATT BLVD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805018500",
            "telephone_number": "303-827-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACE",
        "first_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0025055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.