NPIMap

Individual provider Active NPI

Jahan Keivanjah, PHARMACIST

  • Pharmacist
  • St Thomas, VI
National Provider Identifier
1750730099
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
036527 Issued in NY
Practice address
9000 Lockhart GDN Ctr
Store # 13
St Thomas, VI 00802-2685
Phone
(340) 776-7098
Fax
(340) 776-8030
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 145 VI
Pharmacist 183500000X 036527 NY Primary

Addresses

Primary practice location

9000 Lockhart GDN Ctr
Store # 13
St Thomas, VI 00802-2685

Mailing address

6 N Church St
Goshen, NY 10924-1550
Phone (845) 237-5557

Other identifiers 1

IdentifierTypeStateIssuer
06309219MedicaidNY

Other names 1

  • Mr. Jahn Keivanjah Professional name

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
036527NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
East Main Street Chemists Inc Current Accepting new patients
Cure Pharmacy Care II LLC CurrentSince Feb 13, 2022 Accepting new patients
East Main Street Chemists Inc Current Accepting new patients

Locations

6 N Church St
Goshen, NY 10924
Phone (845) 237-5557

Organizations & group practices 3

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1750730099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 N CHURCH ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241550",
            "telephone_number": "845-237-5557",
            "fax_number": "845-237-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 LOCKHART GDN CTR",
            "address_2": "STORE # 13",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008022685",
            "telephone_number": "340-776-7098",
            "fax_number": "340-776-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIVANJAH",
        "first_name": "JAHAN",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VI",
            "license": "145",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "036527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06309219",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAHN",
            "last_name": "KEIVANJAH",
            "prefix": "MR.",
            "credential": "PHARMACIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Thomas, VI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.