Active NPI
Gannat Moustafa, LPN
- Licensed Practical Nurse
- Richmond, VA
National Provider Identifier
1043175144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 0002107085
- Practice address
- 4926 W Broad St
Richmond, VA 23230-3122 - Phone
- (844) 624-7513
- NPI assigned
- Dec 19, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 0002107085 | VA | Primary |
Addresses
Primary practice location
4926 W Broad St
Richmond, VA 23230-3122
Mailing address
4926 W Broad St
Richmond, VA 23230-3122
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Gannat.moustafa@ctcprograms.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 0002107085 | VA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766102400000",
"number": "1043175144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4926 W BROAD ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232303122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4926 W BROAD ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232303122",
"telephone_number": "844-624-7513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSTAFA",
"first_name": "GANNAT",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-19",
"last_updated": "2025-12-19",
"certification_date": "2025-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "VA",
"license": "0002107085",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Gannat.moustafa@ctcprograms.com",
"affiliation": "N",
"endpointDescription": "work",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "4926 W Broad St",
"city": "Richmond",
"state": "VA",
"country_code": "US",
"postal_code": "232303122",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.