Individual provider Active NPI

Josephine Koomson

  • Pharmacist
  • Chantilly, VA
National Provider Identifier
1740006360
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202222484 Issued in VA
Practice address
14361 Newbrook Dr
Chantilly, VA 20151-4228
Phone
(571) 525-5565
NPI assigned
Nov 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202222484 VA Primary

Addresses

Primary practice location

14361 Newbrook Dr
Chantilly, VA 20151-4228

Mailing address

8911 Virginia Ave
Manassas, VA 20110-6119
Phone (571) 354-9135

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
0202222484VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wegmans Food Markets, Inc. PastSince Dec 1, 2024 Accepting new patients
Wegmans Food Markets, Inc. PastSince Dec 1, 2024 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1740006360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8911 VIRGINIA AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201106119",
            "telephone_number": "571-354-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14361 NEWBROOK DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514228",
            "telephone_number": "571-525-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOMSON",
        "first_name": "JOSEPHINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202222484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.