Individual provider Active NPI

Michael Shen, PHARMD

  • Pharmacist
  • Prince George, VA
National Provider Identifier
1144849654
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202213163 Issued in VA
Practice address
4720 Puddledock Rd Ste 110
Prince George, VA 23875-1275
Phone
(804) 793-8000
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202213163 VA Primary

Addresses

Primary practice location

4720 Puddledock Rd Ste 110
Prince George, VA 23875-1275

Mailing address

8312 Staples Trace Rd
Glen Allen, VA 23060-3454
Phone (443) 614-1567

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

LicenseStateTypeSpecialty
0202213163VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Talis Healthcare LLC CurrentSince Mar 30, 2024 Accepting new patients
VPK Shah Meds LLC PastSince Apr 19, 2020 Accepting new patients

Locations

4720 Puddledock Rd
Ste 110
Prince George, VA 23875
Phone (804) 665-0975

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1144849654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8312 STAPLES TRACE RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603454",
            "telephone_number": "443-614-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 PUDDLEDOCK RD STE 110",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238751275",
            "telephone_number": "804-793-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202213163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince George, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.

Verify at the official NPI Registry.