Active NPI
Ellen Dawn Demucci, PHARMD
- Pharmacist
- Stafford, VA
National Provider Identifier
1790946846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202009712
- Practice address
- 100 Brandice St
Stafford, VA 22554-7197 - Phone
- (540) 429-6299
- NPI assigned
- Jun 20, 2008
- Sex
- Female
- 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 | 0202009712 | VA | Primary |
Addresses
Primary practice location
100 Brandice St
Stafford, VA 22554-7197
Mailing address
100 Brandice St
Stafford, VA 22554-7197
Phone (540) 429-6299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0202009712 | Other | VA | PHARMACY PRACTICE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202009712 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213920000000",
"number": "1790946846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BRANDICE ST",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225547197",
"telephone_number": "540-429-6299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BRANDICE ST",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225547197",
"telephone_number": "540-429-6299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMUCCI",
"first_name": "ELLEN",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-20",
"last_updated": "2008-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202009712",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY PRACTICE LICENSE",
"identifier": "0202009712",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stafford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.