Individual provider Active NPI

Mitchel Craig Rothholz, RPH

  • Pharmacist
  • Alexandria, VA
National Provider Identifier
1649277146
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202011965 Issued in VA
Practice address
4922 Gardner Dr
Alexandria, VA 22304-7732
Phone
(703) 567-6171
Fax
(202) 628-0443
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202011965 VA Primary

Addresses

Primary practice location

4922 Gardner Dr
Alexandria, VA 22304-7732

Mailing address

4922 Gardner Dr
Alexandria, VA 22304-7732
Phone (703) 567-6171

Other identifiers 2

IdentifierTypeStateIssuer
21190OtherFLFL BD OF PHARMACY
0202011965OtherVAVA BD OF PHARMACY

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0202011965VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1649277146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4922 GARDNER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223047732",
            "telephone_number": "703-567-6171",
            "fax_number": "202-628-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 GARDNER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223047732",
            "telephone_number": "703-567-6171",
            "fax_number": "202-628-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHHOLZ",
        "first_name": "MITCHEL",
        "middle_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202011965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BD OF PHARMACY",
            "identifier": "21190",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA BD OF PHARMACY",
            "identifier": "0202011965",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.