Active NPI
Tracey Shotwell, PHARMD
- Pharmacist
- Memphis, TN
National Provider Identifier
1033472097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11264
- Practice address
- 2471 Jackson Ave
Memphis, TN 38108-3318 - Phone
- (901) 454-1615
- NPI assigned
- Jun 24, 2012
- Last updated
- Jun 24, 2012
- Sex
- Female
- 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 | 11264 | TN | Primary |
Addresses
Primary practice location
2471 Jackson Ave
Memphis, TN 38108-3318
Mailing address
913 Abbey Grove LN
Cordova, TN 38018-8216
Phone (901) 737-2458
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11264 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1340496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340496000000",
"number": "1033472097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 ABBEY GROVE LN",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380188216",
"telephone_number": "901-737-2458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2471 JACKSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381083318",
"telephone_number": "901-454-1615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOTWELL",
"first_name": "TRACEY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-24",
"last_updated": "2012-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "11264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.