Individual provider Active NPI

Hanna A Mekonnen, PHARMACIST

  • Pharmacist
  • North Las Vegas, NV
National Provider Identifier
1013631274
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
22895 Issued in NV
Practice address
4755 W Ann Rd
North Las Vegas, NV 89031-3424
Phone
(702) 645-1360
Fax
(702) 396-8514
NPI assigned
Sep 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 22895 NV Primary

Addresses

Primary practice location

4755 W Ann Rd
North Las Vegas, NV 89031-3424

Mailing address

9883 Mount Madera St
Las Vegas, NV 89178-7518
Phone (469) 867-1576

Other identifiers 1

IdentifierTypeStateIssuer
1602642642OtherNVDEIVER LICENCE NUMBER

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

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1013631274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9883 MOUNT MADERA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891787518",
            "telephone_number": "469-867-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 W ANN RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890313424",
            "telephone_number": "702-645-1360",
            "fax_number": "702-396-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKONNEN",
        "first_name": "HANNA",
        "middle_name": "A",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "22895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEIVER LICENCE NUMBER",
            "identifier": "1602642642",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.