Individual provider Active NPI

Ellie Kwon, PHARM.D.

  • Pharmacist
  • Falls Church, VA
National Provider Identifier
1639773922
Registry record updated Nov 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202217924 Issued in VA
Practice address
6360 Seven Corners Ctr
Falls Church, VA 22044-2409
Phone
(703) 534-6688
NPI assigned
Nov 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 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 0202217924 VA Primary

Addresses

Primary practice location

6360 Seven Corners Ctr
Falls Church, VA 22044-2409

Mailing address

6360 Seven Corners Ctr
Falls Church, VA 22044-2409

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elli.kwon@giantfood.com Giant of Maryland LLC

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
0202217924VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1639773922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 SEVEN CORNERS CTR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 SEVEN CORNERS CTR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442409",
            "telephone_number": "703-534-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "ELLIE",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-26",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202217924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elli.kwon@giantfood.com",
            "affiliation": "Y",
            "affiliationName": "Giant of Maryland LLC",
            "address_1": "6360 Seven Corners Ctr",
            "city": "Falls Church",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220442409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.