Active NPI
Dana Willard
- Pharmacist
- Reston, VA
National Provider Identifier
1003364654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202218332
- Practice address
- 11120 S Lakes Dr
Reston, VA 20191-4327 - Phone
- (703) 620-2444
- NPI assigned
- Sep 12, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9826716-1701 | UT | |
| Pharmacist | 183500000X | 0202218332 | VA | Primary |
Addresses
Primary practice location
11120 S Lakes Dr
Reston, VA 20191-4327
Mailing address
11120 S Lakes Dr
Reston, VA 20191-4327
Other practice location 1
851 24th St
Rite Aid
Ogden, UT 84401-2601
Phone (801) 393-6044
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9826716-1701 | UT | MD | Pharmacist |
| 0202218332 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631404800000",
"number": "1003364654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11120 S LAKES DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201914327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11120 S LAKES DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201914327",
"telephone_number": "703-620-2444"
}
],
"practiceLocations": [
{
"address_1": "851 24th St",
"address_2": "Rite Aid",
"address_purpose": "LOCATION",
"city": "Ogden",
"state": "UT",
"postal_code": "844012601",
"country_code": "US",
"telephone_number": "801-393-6044",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLARD",
"first_name": "DANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-12",
"last_updated": "2021-09-12",
"certification_date": "2021-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "9826716-1701",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202218332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.