Individual provider Active NPI

Eric Ndoumbe Ndimasa, PHARMD

  • Pharmacist
  • California, MD
National Provider Identifier
1538575261
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20415 Issued in MD
Practice address
22565 Three Notch Road
California, MD 20619
Phone
(301) 863-5992
Fax
(301) 866-1497
NPI assigned
Jul 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20415 MD Primary

Addresses

Primary practice location

22565 Three Notch Road
California, MD 20619

Mailing address

22565 Three Notch Road
California, MD 20619
Phone (301) 863-5992

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
20415MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1538575261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22565 THREE NOTCH ROAD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "20619",
            "telephone_number": "301-863-5992",
            "fax_number": "301-866-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22565 THREE NOTCH ROAD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "20619",
            "telephone_number": "301-863-5992",
            "fax_number": "301-866-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIMASA",
        "first_name": "ERIC",
        "middle_name": "NDOUMBE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "20415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.