Shawn Robert Smith, PHARMD

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

77377 Issued in CA

Practice address

14049 Amargosa Rd
Victorville, CA 92392-2493

Phone

(760) 515-2464

NPI assigned

Nov 10, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Symba Center

  • Clinic/Center
  • Victorville, CA
  • NPI 1083362297
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1184269482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "909-469-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14049 AMARGOSA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922493",
            "telephone_number": "760-515-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHAWN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-10",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "CA",
            "license": "77377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Endpoint",
            "affiliation": "N",
            "address_1": "16519 Victor St Ste 307",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923953922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles Stuart Smith, RADT R1543910124
• Edwina Smith, RN
• Jessica C Smith, FNP
• Kaden Thomas Smith
• Kasey Smith
• Zamariah Smith
• Nikki Smithson
• John Warren Snider, RADT-I
• Sohail Manzoor, M.D., Inc
• Prinay Sohal, M.B.B.S.

• Ambulatory Care Pharmacist in Victorville, CA
• Providers in Victorville, CA by specialty
• Ambulatory Care Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.