Individual provider Active NPI

Krishna Shah

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Lebanon, NH
National Provider Identifier
1134701113
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PHCY-00999 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 653-3737
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 28RJ05652 NJ
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 28RI03640600 NJ
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH237915 MA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PHCY-00999 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

42 Wolf Rd Unit 322
Lebanon, NH 03766-1953
Phone (732) 318-7853

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

State licenses

LicenseStateTypeSpecialty
PH237915MAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PHCY-00999NHMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
28RI03640600NJMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
28RJ05652NJMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1134701113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 WOLF RD UNIT 322",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661953",
            "telephone_number": "732-318-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KRISHNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NJ",
            "license": "28RJ05652",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NJ",
            "license": "28RI03640600",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MA",
            "license": "PH237915",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NH",
            "license": "PHCY-00999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.