Active NPI
Shanterra Grable, PHARMD
- Pharmacist
- Brunswick, GA
National Provider Identifier
1104438308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH030834
- Practice address
- 101 Torras Dr
Brunswick, GA 31520-4430 - Phone
- (912) 267-0415
- NPI assigned
- Aug 19, 2020
- Last updated
- Dec 22, 2022
- Sex
- Female
- 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 | RPH030834 | GA | Primary |
Addresses
Primary practice location
101 Torras Dr
Brunswick, GA 31520-4430
Mailing address
28 Red Oak Dr
Brunswick, GA 31525-5665
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 |
|---|---|---|---|
| RPH030834 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
101 Torras Dr
Brunswick, GA 31520
Phone (912) 267-0415
Organizations & group practices 3
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": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1104438308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 RED OAK DR",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315255665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 TORRAS DR",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315204430",
"telephone_number": "912-267-0415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRABLE",
"first_name": "SHANTERRA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-19",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH030834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.