Individual provider Active NPI

Susanne Shulleeta, RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Henrico, VA
National Provider Identifier
1164960282
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
020201105 Issued in VA
Practice address
1510 Eastridge Rd
Henrico, VA 23229-5740
Phone
(804) 288-4396
NPI assigned
Feb 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202011055 VA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 020201105 VA Primary

Addresses

Primary practice location

1510 Eastridge Rd
Henrico, VA 23229-5740

Mailing address

2705 Williamsburg Rd
Richmond, VA 23231
Phone (804) 222-2705

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0202011055VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I Past Accepting new patients
Kroger Limited Partnership I 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": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1164960282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 WILLIAMSBURG RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23231",
            "telephone_number": "804-222-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 EASTRIDGE RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232295740",
            "telephone_number": "804-288-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULLEETA",
        "first_name": "SUSANNE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202011055",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VA",
            "license": "020201105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.