Individual provider Active NPI

Ahmed Elwan Mohamed Elhassanny

  • Pharmacist
  • Pearisburg, VA
National Provider Identifier
1104579507
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202220002 Issued in VA
Practice address
121 N Main St
Pearisburg, VA 24134-1624
Phone
(540) 921-1284
NPI assigned
Jan 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 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 0202220002 VA Primary

Addresses

Primary practice location

121 N Main St
Pearisburg, VA 24134-1624

Mailing address

121 N Main St
Pearisburg, VA 24134-1624
Phone (540) 921-1284

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

LicenseStateTypeSpecialty
0202220002VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1104579507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N MAIN ST",
            "city": "PEARISBURG",
            "state": "VA",
            "postal_code": "241341624",
            "telephone_number": "540-921-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N MAIN ST",
            "city": "PEARISBURG",
            "state": "VA",
            "postal_code": "241341624",
            "telephone_number": "540-921-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELHASSANNY",
        "first_name": "AHMED",
        "middle_name": "ELWAN MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202220002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearisburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.