Individual provider Active NPI

Ransford Yayra Djisam, RPH

  • Pharmacist
  • Elkhart, IN
National Provider Identifier
1952899163
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26027010A Issued in IN
Practice address
104 W Hively Ave
Elkhart, IN 46517-2113
Phone
(574) 293-2231
NPI assigned
Apr 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26027010A IN Primary

Addresses

Primary practice location

104 W Hively Ave
Elkhart, IN 46517-2113

Mailing address

104 W Hively Ave
Elkhart, IN 46517-2113
Phone (574) 293-2231

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
26027010AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hook-Superx LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1952899163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W HIVELY AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172113",
            "telephone_number": "574-293-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W HIVELY AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172113",
            "telephone_number": "574-293-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJISAM",
        "first_name": "RANSFORD",
        "middle_name": "YAYRA",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26027010A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.