Active NPI
Shakema Danay Poulson, PHARMD
- Pharmacist
- Suffolk, VA
National Provider Identifier
1053693572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202207153
- Practice address
- 3633 Bridge Rd
Suffolk, VA 23435-1807 - Phone
- (757) 686-4793
- Fax
- (757) 638-7808
- NPI assigned
- Sep 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 0202207153 | VA | Primary |
Addresses
Primary practice location
3633 Bridge Rd
Suffolk, VA 23435-1807
Mailing address
3633 Bridge Rd
Suffolk, VA 23435-1807
Phone (757) 686-4793
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 |
|---|---|---|---|
| 0202207153 | VA | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315612800000",
"number": "1053693572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3633 BRIDGE RD",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234351807",
"telephone_number": "757-686-4793",
"fax_number": "757-638-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3633 BRIDGE RD",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234351807",
"telephone_number": "757-686-4793",
"fax_number": "757-638-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULSON",
"first_name": "SHAKEMA",
"middle_name": "DANAY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-10",
"last_updated": "2011-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202207153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.