Individual provider Active NPI

Thao Minn

  • Pharmacist
  • Broomfield, CO
National Provider Identifier
1962785089
Registry record updated Sep 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15913 Issued in CO
Practice address
12655 Yates St
Broomfield, CO 80020-5789
Phone
(720) 270-5122
NPI assigned
Sep 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15913 CO Primary

Addresses

Primary practice location

12655 Yates St
Broomfield, CO 80020-5789

Mailing address

12655 Yates St
Broomfield, CO 80020-5789

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

State licenses

LicenseStateTypeSpecialty
15913COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316908800000",
    "number": "1962785089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 YATES ST",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 YATES ST",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205789",
            "telephone_number": "720-270-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINN",
        "first_name": "THAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-25",
        "last_updated": "2011-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "15913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.