Individual provider Active NPI

Ivy A Kwapong, PHARMD

  • Pharmacist
  • McLean, VA
National Provider Identifier
1356744361
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202212426 Issued in VA
Practice address
1680 Capital One Dr Ste 100RX
MC Lean, VA 22102-3407
Phone
(571) 581-3147
NPI assigned
Oct 4, 2014
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202212426 VA Primary

Addresses

Primary practice location

1680 Capital One Dr Ste 100RX
MC Lean, VA 22102-3407

Mailing address

1680 Capital One Dr Ste 100RX
MC Lean, VA 22102-3407
Phone (571) 581-3147

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL rxm.21367@store.walgreens.com

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
0202212426VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Dec 28, 2022 Accepting new patients
Walgreen Co PastSince Dec 28, 2022 Accepting new patients

Locations

1680 Capital One Dr
Ste 100RX
McLean, VA 22102
Phone (571) 581-3147

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": "1412380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1356744361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 CAPITAL ONE DR STE 100RX",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023407",
            "telephone_number": "571-581-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 CAPITAL ONE DR STE 100RX",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023407",
            "telephone_number": "571-581-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAPONG",
        "first_name": "IVY",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-04",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202212426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rxm.21367@store.walgreens.com",
            "affiliation": "N",
            "address_1": "1680 Capital One Dr Ste 100Rx",
            "city": "Mc Lean",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221023407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.