NPIMap

Individual provider Active NPI

Shelby E Whitman, PHARMD

  • Pharmacist
  • Winston Salem, NC
National Provider Identifier
1205300761
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28091 Issued in NC
Practice address
189 Hickory Tree Rd Ste 120
Winston Salem, NC 27107-8759
Phone
(336) 764-5310
NPI assigned
Jan 17, 2019
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28091 NC Primary

Addresses

Primary practice location

189 Hickory Tree Rd Ste 120
Winston Salem, NC 27107-8759

Mailing address

189 Hickory Tree Rd Ste 120
Winston Salem, NC 27107-8759
Phone (336) 764-5310

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

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Mar 13, 2022 Accepting new patients
Walgreen Co PastSince Jul 25, 2019 Accepting new patients
Walgreen Co PastSince Jul 25, 2019 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1205300761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 HICKORY TREE RD STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271078759",
            "telephone_number": "336-764-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 HICKORY TREE RD STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271078759",
            "telephone_number": "336-764-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMAN",
        "first_name": "SHELBY",
        "middle_name": "E",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "28091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.