Active NPI
Jay Shin, PHARMD
- Pharmacist
- Birmingham, AL
National Provider Identifier
1104421809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21622
- Practice address
- 4616 US 280
Birmingham, AL 35242 - Phone
- (205) 991-6248
- NPI assigned
- Dec 1, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 21622 | AL | Primary |
Addresses
Primary practice location
4616 US 280
Birmingham, AL 35242
Mailing address
2801 Riverview Rd Apt 1311
Birmingham, AL 35242-4737
Phone (713) 515-3048
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 |
|---|---|---|---|
| 21622 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1104421809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 RIVERVIEW RD APT 1311",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352424737",
"telephone_number": "713-515-3048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4616 US 280",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35242",
"telephone_number": "205-991-6248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "JAY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-01",
"last_updated": "2020-12-01",
"certification_date": "2020-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "21622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.