Individual provider Active NPI

Mariam Rahmani, M.D.

  • Child & Adolescent Psychiatry Physician
  • Norfolk, VA
National Provider Identifier
1568690956
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
0101279543 Issued in VA
Practice address
850 Southampton Ave
Norfolk, VA 23510-1021
Phone
(757) 668-4673
NPI assigned
Jun 24, 2009
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME109465 FL
Child & Adolescent Psychiatry Physician 2084P0804X 0101279543 VA Primary

Addresses

Primary practice location

850 Southampton Ave
Norfolk, VA 23510-1021

Mailing address

PO Box 13833
Philadelphia, PA 19101-3833
Phone (352) 265-0301

Other identifiers 1

IdentifierTypeStateIssuer
009264000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130627000704 FL Practitioner - Psychiatry 0648410456 Reassigns benefits to 1 organization
I20240328000269 VA Practitioner - Psychiatry 0648410456 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME109465FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2014 Accepting new patients
Childrens Specialty Group PLLC CurrentSince Feb 10, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2014 Accepting new patients
Family Preservation Services Past Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

850 Southampton Ave
Norfolk, VA 23510
Phone (757) 668-4673

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1568690956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13833",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013833",
            "telephone_number": "352-265-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SOUTHAMPTON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101021",
            "telephone_number": "757-668-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMANI",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME109465",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101279543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009264000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.