Active NPI
Ibtisam Mahrous
- Pharmacist
- West Monroe, LA
National Provider Identifier
1386256410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 023498
- Practice address
- 5349 Cypress St
West Monroe, LA 71291-7505 - Phone
- (318) 397-8152
- NPI assigned
- Aug 19, 2020
- Last updated
- Aug 19, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 023498 | LA | Primary |
Addresses
Primary practice location
5349 Cypress St
West Monroe, LA 71291-7505
Mailing address
521 Shady LN
Monroe, LA 71203-2236
Phone (318) 351-6655
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023498 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
5349 Cypress St
West Monroe, LA 71291
Phone (318) 397-8152
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": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1386256410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 SHADY LN",
"city": "MONROE",
"state": "LA",
"postal_code": "712032236",
"telephone_number": "318-351-6655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5349 CYPRESS ST",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712917505",
"telephone_number": "318-397-8152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHROUS",
"first_name": "IBTISAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-19",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "023498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Monroe, LA
- M. Dwayne Yeager, OD, Faao, a Professional Organization
- Ashton Machen, PHARMD
- Wess Allen Magee, MOT, LOTR
- Magnolia Healthcare PA LLC (Magnolia Healthcare PA, LLC dba Therapeutic Healthcare)
- Maguire Plastic Surgery, LLC
- Torri Rayne Mahrous, FNP
- Majure Physical Therapy, L.L.C.
- Sarah Michelle Malone, FNP-C
- Megan Maranto, CF-SLP
- Julius Christian Marcus, LMSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.