Individual provider Active NPI

Abdou Bojang, PHARMD

  • Pharmacist
  • Louisville, KY
National Provider Identifier
1902445752
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26021631A Issued in IN
Practice address
4009 Poplar Level Rd
Louisville, KY 40213-1523
Phone
(502) 454-4106
Fax
(502) 454-6328
NPI assigned
Dec 26, 2019
Last updated
Dec 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 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 26021631A IN Primary

Addresses

Primary practice location

4009 Poplar Level Rd
Louisville, KY 40213-1523

Mailing address

7111 Welchire Falls Dr
Louisville, KY 40228-1695
Phone (502) 454-4106

Other identifiers 1

IdentifierTypeStateIssuer
NONEMedicaidKY

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ABDOU.BOJANG@STORES.KROGER.COM Direct
Direct Messaging Address ABDOU.BOJANG@STORES.KROGER.COM Direct
Direct Messaging Address ABDOU.BOJANG@STORES.KROGER.COM Direct

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
26021631AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I PastSince Dec 29, 2019 Accepting new patients
Kroger Limited Partnership I PastSince Dec 29, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: abdou.bojang@stores.kroger.com

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": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1902445752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 WELCHIRE FALLS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402281695",
            "telephone_number": "502-454-4106",
            "fax_number": "502-454-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 POPLAR LEVEL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131523",
            "telephone_number": "502-454-4106",
            "fax_number": "502-454-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOJANG",
        "first_name": "ABDOU",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-26",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26021631A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABDOU.BOJANG@STORES.KROGER.COM",
            "affiliation": "N",
            "endpointDescription": "WORK LOCATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4009 Poplar Level Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402131523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABDOU.BOJANG@STORES.KROGER.COM",
            "affiliation": "N",
            "endpointDescription": "WORK EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4009 Poplar Level Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402131523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABDOU.BOJANG@STORES.KROGER.COM",
            "affiliation": "N",
            "endpointDescription": "WORK EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4009 Poplar Level Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402131523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.