Individual provider Active NPI

Marcia A Shaffer, RPH

  • Pharmacotherapy Pharmacist
  • Lafayette, IN
National Provider Identifier
1043622350
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
26018391A Issued in IN
Practice address
4901 State Road 26 E
Lafayette, IN 47905-4611
Phone
(765) 449-9233
Fax
(765) 449-9265
NPI assigned
May 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 26018391A IN Primary

Addresses

Primary practice location

4901 State Road 26 E
Lafayette, IN 47905-4611

Mailing address

4901 State Road 26 E
Lafayette, IN 47905-4611
Phone (765) 449-9233

Other identifiers 1

IdentifierTypeStateIssuer
26018391AOtherINPHARMACIST LICENSE

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
26018391AINMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1043622350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 STATE ROAD 26 E",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054611",
            "telephone_number": "765-449-9233",
            "fax_number": "765-449-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 STATE ROAD 26 E",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054611",
            "telephone_number": "765-449-9233",
            "fax_number": "765-449-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "MARCIA",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IN",
            "license": "26018391A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "26018391A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.