Active NPI
Seyedali Mortazavi Rad
- Pharmacist
- Johns Creek, GA
National Provider Identifier
1083356372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH032970
- Practice address
- 1010 Bay Tree LN
Johns Creek, GA 30097-5960 - Phone
- (941) 524-4888
- NPI assigned
- Apr 8, 2022
- 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 | RPH032970 | GA | Primary |
Addresses
Primary practice location
1010 Bay Tree LN
Johns Creek, GA 30097-5960
Mailing address
1010 Bay Tree LN
Johns Creek, GA 30097-5960
Phone (941) 524-4888
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 |
|---|---|---|---|
| RPH032970 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1083356372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 BAY TREE LN",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300975960",
"telephone_number": "941-524-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 BAY TREE LN",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300975960",
"telephone_number": "941-524-4888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTAZAVI RAD",
"first_name": "SEYEDALI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-08",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH032970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Creek, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.