Individual provider Active NPI

Coral Cruz, PHARMACIST

  • Ambulatory Care Pharmacist
  • Springfield, VA
National Provider Identifier
1134655327
Registry record updated May 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
0202211978 Issued in VA
Practice address
6501 Loisdale CT
Springfield, VA 22150-1826
Phone
(703) 922-1014
NPI assigned
May 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0018850 CO
Ambulatory Care Pharmacist 1835P2201X 0202211978 VA Primary

Addresses

Primary practice location

6501 Loisdale CT
Springfield, VA 22150-1826

Mailing address

300 Yoakum Pkwy Apt 903
Alexandria, VA 22304-4057
Phone (720) 935-4172

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
0018850COMDPharmacist
0202211978VAMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1494115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494115200000",
    "number": "1134655327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 YOAKUM PKWY APT 903",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044057",
            "telephone_number": "720-935-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 LOISDALE CT",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221501826",
            "telephone_number": "703-922-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "CORAL",
        "name_prefix": "Dr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-07",
        "last_updated": "2017-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0018850",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "VA",
            "license": "0202211978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2017; 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.