Individual provider Active NPI

Lisa Marie Shull, RPH

  • Pharmacist
  • North Augusta, SC
National Provider Identifier
1043500044
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
007611 Issued in SC
Practice address
401 Martintown Rd
North Augusta, SC 29841-3175
Phone
(803) 279-1610
NPI assigned
Apr 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 007611 SC Primary

Addresses

Primary practice location

401 Martintown Rd
North Augusta, SC 29841-3175

Mailing address

50 Wildmeade CT
North Augusta, SC 29841-6062
Phone (803) 279-0309

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
007611SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation 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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1043500044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 WILDMEADE CT",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298416062",
            "telephone_number": "803-279-0309",
            "fax_number": "803-819-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MARTINTOWN RD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298413175",
            "telephone_number": "803-279-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "007611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Augusta, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.