Individual provider Active NPI

Avideh Ramezanifar, PHARMD

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1790347334
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHI-020736 Issued in GA
Practice address
2345 Peachtree Rd NE
Atlanta, GA 30305-4147
Phone
(404) 233-2101
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHI-020736 GA Primary

Addresses

Primary practice location

2345 Peachtree Rd NE
Atlanta, GA 30305-4147

Mailing address

2144 Peachtree Rd NW Apt 1026
Atlanta, GA 30309-1768
Phone (615) 496-0186

Other practice location 1

3001 Mercer University Dr
Atlanta, GA 30341-4115
Phone (678) 547-6232

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PHI-020736GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1790347334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 PEACHTREE RD NW APT 1026",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091768",
            "telephone_number": "615-496-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303054147",
            "telephone_number": "404-233-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Mercer University Dr",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303414115",
            "country_code": "US",
            "telephone_number": "678-547-6232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMEZANIFAR",
        "first_name": "AVIDEH",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "PHI-020736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.