Active NPI
Sandra Shimak
- Pharmacist
- Clinton, IA
National Provider Identifier
1184026767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19062
- Practice address
- 1307 N 2ND St
Clinton, IA 52732-5243 - Phone
- (563) 243-6641
- NPI assigned
- Sep 25, 2014
- Sex
- Female
- 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 | 19062 | IA | Primary |
Addresses
Primary practice location
1307 N 2ND St
Clinton, IA 52732-5243
Mailing address
567 Squaw Creek Cir
Marion, IA 52302-9039
Phone (319) 551-7818
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19062 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411603200000",
"number": "1184026767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "567 SQUAW CREEK CIR",
"city": "MARION",
"state": "IA",
"postal_code": "523029039",
"telephone_number": "319-551-7818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 N 2ND ST",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325243",
"telephone_number": "563-243-6641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMAK",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-25",
"last_updated": "2014-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "19062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.