Active NPI
Youssef Khalifa, RPH
- Pharmacist
- Bozeman, MT
National Provider Identifier
1760087969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6936
- Practice address
- 115 N 19TH Ave
Bozeman, MT 59718-4072 - Phone
- (406) 587-9252
- NPI assigned
- Dec 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6936 | MT | Primary |
Addresses
Primary practice location
115 N 19TH Ave
Bozeman, MT 59718-4072
Mailing address
2772 Tempest CT
Bozeman, MT 59718-6109
Phone (319) 610-3091
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6936 | MT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montana CVS Pharmacy LLC | Past | Accepting new patients | |
| Montana CVS Pharmacy LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Renton, WA
- NPI 1700242740
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1760087969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2772 TEMPEST CT",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597186109",
"telephone_number": "319-610-3091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N 19TH AVE",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597184072",
"telephone_number": "406-587-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALIFA",
"first_name": "YOUSSEF",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "6936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.