Active NPI
Rahul Tryambak Khisti
- Pharmacist
- Ashland, VA
National Provider Identifier
1033486089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202208235
- Practice address
- 133 Junction Dr
Ashland, VA 23005-2253 - Phone
- (804) 752-2093
- Fax
- (804) 798-8995
- NPI assigned
- Nov 18, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202208235 | VA | Primary |
Addresses
Primary practice location
133 Junction Dr
Ashland, VA 23005-2253
Mailing address
133 Junction Dr
Ashland, VA 23005-2253
Phone (804) 752-2093
Other practice location 1
3715 Mechanicsville Tpke
Richmond, VA 23223-1331
Phone (804) 329-1555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T63697222 | Other | VA | DRIVING LICENSE |
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 |
|---|---|---|---|
| 0202208235 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1321574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1033486089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 JUNCTION DR",
"city": "ASHLAND",
"state": "VA",
"postal_code": "230052253",
"telephone_number": "804-752-2093",
"fax_number": "804-798-8995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 JUNCTION DR",
"city": "ASHLAND",
"state": "VA",
"postal_code": "230052253",
"telephone_number": "804-752-2093",
"fax_number": "804-798-8995"
}
],
"practiceLocations": [
{
"address_1": "3715 Mechanicsville Tpke",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232231331",
"country_code": "US",
"telephone_number": "804-329-1555",
"fax_number": "804-329-2763",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHISTI",
"first_name": "RAHUL",
"middle_name": "TRYAMBAK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-18",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202208235",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVING LICENSE",
"identifier": "T63697222",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.