Active NPI
Shahram Kazemi-Movahed
- Pharmacist
- Hephzibah, GA
National Provider Identifier
1790381630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH032577
- Practice address
- 2493 Tobacco Rd
Hephzibah, GA 30815-5951 - Phone
- (706) 793-2106
- NPI assigned
- Dec 7, 2020
- Sex
- Male
- Sole proprietor
- No
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 | RPH032577 | GA | Primary |
Addresses
Primary practice location
2493 Tobacco Rd
Hephzibah, GA 30815-5951
Mailing address
2493 Tobacco Rd
Hephzibah, GA 30815-5951
Phone (706) 793-2106
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH032577 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2493 Tobacco Rd
Hephzibah, GA 30815
Phone (706) 793-2106
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1790381630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2493 TOBACCO RD",
"city": "HEPHZIBAH",
"state": "GA",
"postal_code": "308155951",
"telephone_number": "706-793-2106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2493 TOBACCO RD",
"city": "HEPHZIBAH",
"state": "GA",
"postal_code": "308155951",
"telephone_number": "706-793-2106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZEMI-MOVAHED",
"first_name": "SHAHRAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH032577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hephzibah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.