Active NPI
Ibrahim Ahsan
- Pharmacist
- La Crosse, WI
National Provider Identifier
1922632397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18619-40
- Practice address
- 1105 Wi-16
La Crosse, WI 54601 - Phone
- (608) 779-0939
- NPI assigned
- Feb 25, 2020
- Last updated
- Feb 25, 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 | 18619-40 | WI | Primary |
Addresses
Primary practice location
1105 Wi-16
La Crosse, WI 54601
Mailing address
1010 Berry Ave Apt 218
Tomah, WI 54660-4464
Phone (608) 387-1924
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 |
|---|---|---|---|
| 18619-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1922632397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 BERRY AVE APT 218",
"city": "TOMAH",
"state": "WI",
"postal_code": "546604464",
"telephone_number": "608-387-1924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 WI-16",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "54601",
"telephone_number": "608-779-0939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHSAN",
"first_name": "IBRAHIM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-25",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "18619-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.