Individual provider Active NPI

Nadia Rezaeian

  • Pharmacist
  • Potomac, MD
National Provider Identifier
1649664574
Registry record updated Mar 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202213739 Issued in VA
Practice address
13141 Brushwood Way
Potomac, MD 20854-1025
Phone
(301) 233-3630
NPI assigned
Mar 28, 2015
Last updated
Mar 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202213739 VA Primary

Addresses

Primary practice location

13141 Brushwood Way
Potomac, MD 20854-1025

Mailing address

13141 Brushwood Way
Potomac, MD 20854-1025

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

State licenses

LicenseStateTypeSpecialty
0202213739VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427500800000",
    "number": "1649664574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13141 BRUSHWOOD WAY",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13141 BRUSHWOOD WAY",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541025",
            "telephone_number": "301-233-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAEIAN",
        "first_name": "NADIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-28",
        "last_updated": "2015-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202213739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2015; 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.