Individual provider Active NPI

Hayat A Ezzat, PHARMD

  • Pharmacist
  • Minneapolis, MN
National Provider Identifier
1467746586
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
120309 Issued in MN
Practice address
425 13TH Ave SE
Apt 1804
Minneapolis, MN 55414-2065
Phone
(612) 205-3384
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 120309 MN Primary

Addresses

Primary practice location

425 13TH Ave SE
Apt 1804
Minneapolis, MN 55414-2065

Mailing address

425 13TH Ave SE
Apt 1804
Minneapolis, MN 55414-2065
Phone (612) 205-3384

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
120309MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1467746586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 13TH AVE SE",
            "address_2": "APT 1804",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142065",
            "telephone_number": "612-205-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 13TH AVE SE",
            "address_2": "APT 1804",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142065",
            "telephone_number": "612-205-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZAT",
        "first_name": "HAYAT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "120309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.