Individual provider Active NPI

Leah Walling Mavromihalis, PHARM.D.

  • Pharmacist
  • Biloxi, MS
National Provider Identifier
1336175579
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E09733 Issued in MS
Practice address
400 Veterans Ave
Pharmacy Service - 119
Biloxi, MS 39531-2410
Phone
(228) 523-5000
NPI assigned
Jun 22, 2006
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E09733 MS Primary

Addresses

Primary practice location

400 Veterans Ave
Pharmacy Service - 119
Biloxi, MS 39531-2410

Mailing address

400 Veterans Ave
Biloxi, MS 39531-2410
Phone (228) 217-8881

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

LicenseStateTypeSpecialty
E09733MSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1336175579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 VETERANS AVE",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312410",
            "telephone_number": "228-217-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VETERANS AVE",
            "address_2": "PHARMACY SERVICE - 119",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312410",
            "telephone_number": "228-523-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVROMIHALIS",
        "first_name": "LEAH",
        "middle_name": "WALLING",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E09733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.