Individual provider Active NPI

Thomas Shaw, PHARM.D.

  • Pharmacist
  • Peoria, AZ
National Provider Identifier
1043643794
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020052 Issued in AZ
Practice address
13260 N 94TH Dr Ste 102
Peoria, AZ 85381-4242
Phone
(623) 583-2045
Fax
(888) 605-4090
NPI assigned
Aug 16, 2013
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020052 AZ Primary

Addresses

Primary practice location

13260 N 94TH Dr Ste 102
Peoria, AZ 85381-4242

Mailing address

1034 W Spur Dr
Phoenix, AZ 85085-6369
Phone (602) 509-2863

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

LicenseStateTypeSpecialty
S020052AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoran Drugs CurrentSince Jan 14, 2024 Accepting new patients
Shaw Health LLC CurrentSince Jan 14, 2024 Accepting new patients

Locations

13260 N 94th Dr
Ste 102
Peoria, AZ 85381
Phone (623) 209-0109

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": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1043643794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 W SPUR DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856369",
            "telephone_number": "602-509-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13260 N 94TH DR STE 102",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814242",
            "telephone_number": "623-583-2045",
            "fax_number": "888-605-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-16",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.