Individual provider Active NPI

Boussina A Moussa, RPH

  • Pharmacist
  • North Platte, NE
National Provider Identifier
1881168169
Registry record updated Jan 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16280 Issued in NE
Practice address
1401 S Dewey St
North Platte, NE 69101-7650
Phone
(308) 532-5830
NPI assigned
Jan 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 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 16280 NE Primary

Addresses

Primary practice location

1401 S Dewey St
North Platte, NE 69101-7650

Mailing address

1401 S Dewey St
North Platte, NE 69101-7650
Phone (308) 532-5830

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

LicenseStateTypeSpecialty
16280NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1547856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547856000000",
    "number": "1881168169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S DEWEY ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691017650",
            "telephone_number": "308-532-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S DEWEY ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691017650",
            "telephone_number": "308-532-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSSA",
        "first_name": "BOUSSINA",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-19",
        "last_updated": "2019-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "16280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.