Individual provider Active NPI

Mohammad Ali-Shan Javid, PHARMD

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1447633862
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP446505 Issued in PA
Practice address
4511 N 5TH St
Philadelphia, PA 19140-2309
Phone
(215) 457-5555
Fax
(215) 457-8340
NPI assigned
Jul 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP446505 PA Primary
Pharmacist 183500000X A1-0004312 DE
Pharmacist 183500000X 28RI03505300 NJ
Pharmacist 183500000X 28RJ04275 NJ
Pharmacist 183500000X RPI006361 PA
Pharmacist 183500000X 059473 NY

Addresses

Primary practice location

4511 N 5TH St
Philadelphia, PA 19140-2309

Mailing address

4511 N 5TH St
Philadelphia, PA 19140-2309
Phone (215) 457-5555

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
059473NYMDDentist
A1-0004312DEMDPharmacist
28RI03505300NJMDPharmacist
28RJ04275NJMDPharmacist
RP446505PAMDPharmacist
RPI006361PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Riaz U Rahman Past Accepting new patients

Organizations & group practices 1

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1447633862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402309",
            "telephone_number": "215-457-5555",
            "fax_number": "215-457-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402309",
            "telephone_number": "215-457-5555",
            "fax_number": "215-457-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVID",
        "first_name": "MOHAMMAD",
        "middle_name": "ALI-SHAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP446505",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0004312",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03505300",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RJ04275",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RPI006361",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059473",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.