Individual provider Active NPI

Remonda Ishak

  • Pharmacist
  • Mount Juliet, TN
National Provider Identifier
1932774452
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
044040 Issued in TN
Practice address
112 Wynfield Blvd
Mount Juliet, TN 37122-1560
Phone
(615) 715-3518
NPI assigned
May 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 044040 TN Primary

Addresses

Primary practice location

112 Wynfield Blvd
Mount Juliet, TN 37122-1560

Mailing address

112 Wynfield Blvd
Mount Juliet, TN 37122-1560

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

LicenseStateTypeSpecialty
044040TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1932774452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WYNFIELD BLVD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371221560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WYNFIELD BLVD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371221560",
            "telephone_number": "615-715-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHAK",
        "first_name": "REMONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "044040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.