Individual provider Active NPI

Mooath Omar Al-Jarrah, MBBS

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1730008087
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116042851 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-0816
Phone
(434) 924-9400
Fax
(434) 243-6731
NPI assigned
Jul 13, 2026
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
Student in an Organized Health Care Education/Training Program 390200000X 0116042851 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-0816

Mailing address

1215 Lee St
Box ''800377''
Charlottesville, VA 22908-0816
Phone (434) 924-9400

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

NPI Registry JSON

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

{
    "created_epoch": "1783900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730008087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "BOX ''800377''",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-9400",
            "fax_number": "434-243-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-9400",
            "fax_number": "434-243-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-JARRAH",
        "first_name": "MOOATH",
        "middle_name": "OMAR",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116042851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, 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.