Individual provider Active NPI

Golnaz Rezvani, RPH

  • Pharmacist
  • Reston, VA
National Provider Identifier
1336740174
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202012300 Issued in VA
Practice address
1450 North Point Village Center
Reston, VA 20194
Phone
(703) 437-0037
Fax
(844) 411-6507
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202012300 VA Primary

Addresses

Primary practice location

1450 North Point Village Center
Reston, VA 20194

Mailing address

1450 Northpoint Village Ctr
Reston, VA 20194-1190
Phone (703) 437-0037

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL RESTON Health Information Exchange (HIE)

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0202012300VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Giant of Maryland LLC PastSince Nov 8, 2020 Accepting new patients
Giant of Maryland LLC PastSince Nov 8, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: justin1336740174@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1336740174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 NORTHPOINT VILLAGE CTR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941190",
            "telephone_number": "703-437-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 NORTH POINT VILLAGE CENTER",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20194",
            "telephone_number": "703-437-0037",
            "fax_number": "844-411-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZVANI",
        "first_name": "GOLNAZ",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202012300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "RESTON",
            "affiliation": "N",
            "endpointDescription": "COMPUTER",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "RESTON",
            "address_1": "1450 Northpoint Village Ctr",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201941190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.