Active NPI
Hodan Ahmed Mousse, PHARMD
- Pharmacist
- Massillon, OH
National Provider Identifier
1336767045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03337146
- Practice address
- 1130 Lincoln Way E
Massillon, OH 44646-6951 - Phone
- (330) 830-6459
- NPI assigned
- Jul 9, 2020
- 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 | 03337146 | OH | Primary |
Addresses
Primary practice location
1130 Lincoln Way E
Massillon, OH 44646-6951
Mailing address
1878 Barrington Dr
Jonesboro, GA 30236-5903
Phone (678) 548-6016
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 |
|---|---|---|---|
| 03337146 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio CVS Stores, L.L.C. | Past | Accepting new patients | |
| Ohio CVS Stores 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1336767045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1878 BARRINGTON DR",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302365903",
"telephone_number": "678-548-6016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 LINCOLN WAY E",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446466951",
"telephone_number": "330-830-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSSE",
"first_name": "HODAN",
"middle_name": "AHMED",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-09",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03337146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.