Individual provider Active NPI

Mohammad Naveed Makhdoom

  • Pharmacist
  • Dumfries, VA
National Provider Identifier
1962823468
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202211601 Issued in VA
Practice address
4424 Fortuna Center Plaza
Dumfries, VA 22025-4819
Phone
(703) 583-3633
NPI assigned
Dec 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202211601 VA Primary

Addresses

Primary practice location

4424 Fortuna Center Plaza
Dumfries, VA 22025-4819

Mailing address

4424 Fortuna Center Plaza
Dumfries, VA 22025-4819

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
0202211601VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1962823468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 FORTUNA CENTER PLAZA",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220254819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 FORTUNA CENTER PLAZA",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220254819",
            "telephone_number": "703-583-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHDOOM",
        "first_name": "MOHAMMAD NAVEED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-30",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202211601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.