Individual provider Active NPI

Sorour Khaleghian, PHARMD

  • Pharmacist
  • Athens, GA
National Provider Identifier
1417557083
Registry record updated Oct 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH028520 Issued in GA
Practice address
4375 Lexington Rd
Athens, GA 30605-2525
Phone
(706) 355-3090
NPI assigned
Oct 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH028520 GA Primary

Addresses

Primary practice location

4375 Lexington Rd
Athens, GA 30605-2525

Mailing address

4375 Lexington Rd
Athens, GA 30605-2525

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
RPH028520GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604102400000",
    "number": "1417557083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 LEXINGTON RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306052525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 LEXINGTON RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306052525",
            "telephone_number": "706-355-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALEGHIAN",
        "first_name": "SOROUR",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-31",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH028520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.