Individual provider Active NPI

Ajongako Atabong

  • Pharmacist
  • Falls Church, VA
National Provider Identifier
1396525713
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202221538 Issued in VA
Practice address
134 W Broad St
Falls Church, VA 22046-4201
Phone
(703) 538-4835
NPI assigned
Oct 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202221538 VA Primary

Addresses

Primary practice location

134 W Broad St
Falls Church, VA 22046-4201

Mailing address

775 Gateway Dr SE Apt 315
Leesburg, VA 20175-4037

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

LicenseStateTypeSpecialty
0202221538VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1396525713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 GATEWAY DR SE APT 315",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W BROAD ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220464201",
            "telephone_number": "703-538-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATABONG",
        "first_name": "AJONGAKO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202221538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.