Active NPI
Joanna Shin
- Pharmacist
- Flowery Branch, GA
National Provider Identifier
1205456662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH035290
- Practice address
- 4050 Winder Hwy
Flowery Branch, GA 30542-3021 - Phone
- (770) 965-1979
- NPI assigned
- Apr 25, 2020
- Last updated
- Feb 18, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH035290 | GA | Primary |
Addresses
Primary practice location
4050 Winder Hwy
Flowery Branch, GA 30542-3021
Mailing address
180 Passaic Ave BLDG B
Fairfield, NJ 07004-3516
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 |
|---|---|---|---|
| RPH035290 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients |
Organizations & group practices 2
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": "1587772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1205456662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 PASSAIC AVE BLDG B",
"city": "FAIRFIELD",
"state": "NJ",
"postal_code": "070043516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4050 WINDER HWY",
"city": "FLOWERY BRANCH",
"state": "GA",
"postal_code": "305423021",
"telephone_number": "770-965-1979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "JOANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-25",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH035290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flowery Branch, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.