Active NPI
Nadzeya Khomich, PHARMD
- Pharmacist
- Greenbrae, CA
National Provider Identifier
1184214181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 84001
- Practice address
- 330 Bon Air Ctr
Greenbrae, CA 94904-3017 - Phone
- (415) 461-9093
- NPI assigned
- Jan 22, 2021
- Last updated
- Jan 27, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 84001 | CA | Primary |
Addresses
Primary practice location
330 Bon Air Ctr
Greenbrae, CA 94904-3017
Mailing address
330 Bon Air Ctr
Greenbrae, CA 94904-3017
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 |
|---|---|---|---|
| 84001 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611705600000",
"number": "1184214181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BON AIR CTR",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949043017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BON AIR CTR",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949043017",
"telephone_number": "415-461-9093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOMICH",
"first_name": "NADZEYA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-22",
"last_updated": "2021-01-27",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "84001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.