Individual provider Active NPI

Shery I Grosjean, PHARMD

  • Pharmacist
  • Fort Wayne, IN
National Provider Identifier
1184907412
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26022269A Issued in IN
Practice address
11104 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone
(260) 266-4545
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26022269A IN Primary

Addresses

Primary practice location

11104 Parkview Circle Dr
Fort Wayne, IN 46845-1730

Mailing address

11104 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone (260) 266-4545

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

LicenseStateTypeSpecialty
26022269AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1184907412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451730",
            "telephone_number": "260-266-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451730",
            "telephone_number": "260-266-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSJEAN",
        "first_name": "SHERY",
        "middle_name": "I",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26022269A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; 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.