Individual provider Active NPI

Brian P Shevlin, R.PH.

  • Pharmacist
  • Fairport, NY
National Provider Identifier
1093919565
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
044742-1 Issued in NY
Practice address
6707 Pittsford Palmyra Rd
Fairport, NY 14450-3442
Phone
(585) 360-1814
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 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 044742-1 NY Primary

Addresses

Primary practice location

6707 Pittsford Palmyra Rd
Fairport, NY 14450-3442

Mailing address

6707 Pittsford Palmyra Rd
Fairport, NY 14450-3442
Phone (585) 360-1814

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
044742-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Mar 27, 2022 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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1093919565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 PITTSFORD PALMYRA RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503442",
            "telephone_number": "585-360-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 PITTSFORD PALMYRA RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503442",
            "telephone_number": "585-360-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVLIN",
        "first_name": "BRIAN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "044742-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.