Individual provider Active NPI

Obinna Obi-Eyisi, PHARMD

  • Pharmacist
  • Washington, DC
National Provider Identifier
1336745579
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH100000995 Issued in DC
Practice address
661 Pennsylvania Ave SE
Washington, DC 20003-4303
Phone
(202) 543-3305
Fax
(202) 548-3082
NPI assigned
Dec 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20615 MD
Pharmacist 183500000X PH100000995 DC Primary

Addresses

Primary practice location

661 Pennsylvania Ave SE
Washington, DC 20003-4303

Mailing address

2333 Laconia CT
Crofton, MD 21114-3227
Phone (917) 279-9018

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
PH100000995DCMDPharmacist
20615MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
District of Columbia CVS Pharmacy, L.L.C. PastSince Dec 13, 2020 Accepting new patients

Organizations & group practices 1

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1336745579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 LACONIA CT",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211143227",
            "telephone_number": "917-279-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034303",
            "telephone_number": "202-543-3305",
            "fax_number": "202-548-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBI-EYISI",
        "first_name": "OBINNA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "20615",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DC",
            "license": "PH100000995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.