Active NPI
Shamika Latasha Clinton, PHARMD
- Pharmacist
- Warner Robins, GA
National Provider Identifier
1174640601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH023264
- Practice address
- 2929 Watson Blvd
Warner Robins, GA 31093-8535 - Phone
- (478) 971-2557
- Fax
- (478) 971-2557
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH023264 | GA | Primary |
| Pharmacist | 183500000X | 11422 | SC |
Addresses
Primary practice location
2929 Watson Blvd
Warner Robins, GA 31093-8535
Mailing address
2929 Watson Blvd
Warner Robins, GA 31093-8535
Phone (478) 971-2557
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 |
|---|---|---|---|
| RPH023264 | GA | MD | Pharmacist |
| 11422 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270080000000",
"number": "1174640601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 WATSON BLVD",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310938535",
"telephone_number": "478-971-2557",
"fax_number": "478-971-2557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 WATSON BLVD",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310938535",
"telephone_number": "478-971-2557",
"fax_number": "478-971-2557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINTON",
"first_name": "SHAMIKA",
"middle_name": "LATASHA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2010-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH023264",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "11422",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warner Robins, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.