Active NPI
Mohamed Brakta
- Pharmacist
- Kenner, LA
National Provider Identifier
1811396831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17426
- Practice address
- 9 Dogwood Dr
Kenner, LA 70065-6632 - Phone
- (504) 201-2639
- NPI assigned
- Aug 14, 2014
- 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 | 17426 | LA | Primary |
Addresses
Primary practice location
9 Dogwood Dr
Kenner, LA 70065-6632
Mailing address
9 Dogwood Dr
Kenner, LA 70065-6632
Phone (504) 201-2639
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 |
|---|---|---|---|
| 17426 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1811396831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 DOGWOOD DR",
"city": "KENNER",
"state": "LA",
"postal_code": "700656632",
"telephone_number": "504-201-2639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 DOGWOOD DR",
"city": "KENNER",
"state": "LA",
"postal_code": "700656632",
"telephone_number": "504-201-2639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAKTA",
"first_name": "MOHAMED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "17426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenner, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.