Active NPI
Shawn Michael Signor, PHARMD
- Pharmacist
- Watertown, NY
National Provider Identifier
1154665065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 056685
- Practice address
- 128 W Main St
Watertown, NY 13601-1989 - Phone
- (315) 782-5961
- Fax
- (315) 782-4496
- NPI assigned
- Nov 15, 2012
- 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 | 056685 | NY | Primary |
Addresses
Primary practice location
128 W Main St
Watertown, NY 13601-1989
Mailing address
128 W Main St
Watertown, NY 13601-1989
Phone (315) 782-5961
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 |
|---|---|---|---|
| 056685 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boltons Pharmacy Inc | Pharmacist | Past | Accepting new patients |
| Boltons Pharmacy Inc | Past | 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": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1154665065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 W MAIN ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136011989",
"telephone_number": "315-782-5961",
"fax_number": "315-782-4496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 W MAIN ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136011989",
"telephone_number": "315-782-5961",
"fax_number": "315-782-4496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIGNOR",
"first_name": "SHAWN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "056685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.