Active NPI
Evan Mack Sisson, PHARM.D.
- Pharmacotherapy Pharmacist
- Richmond, VA
National Provider Identifier
1174662472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 0202010769
- Practice address
- 410 N 12TH St
Richmond, VA 23298-5062 - Phone
- (804) 828-8076
- Fax
- (804) 828-8359
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 0202010769 | VA | Primary |
Addresses
Primary practice location
410 N 12TH St
Richmond, VA 23298-5062
Mailing address
6006 Hidden Arbor PL
Chester, VA 23831-7749
Phone (804) 748-3085
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202010769 | VA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174662472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6006 HIDDEN ARBOR PL",
"city": "CHESTER",
"state": "VA",
"postal_code": "238317749",
"telephone_number": "804-748-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 N 12TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232985062",
"telephone_number": "804-828-8076",
"fax_number": "804-828-8359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISSON",
"first_name": "EVAN",
"middle_name": "MACK",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "VA",
"license": "0202010769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.