Active NPI
Shannon Brown
- Pharmacist
- Stone Mountain, GA
National Provider Identifier
1225311558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH022863
- Practice address
- 4765 Redan Rd
Stone Mountain, GA 30088-4550 - Phone
- (404) 299-5322
- NPI assigned
- Sep 22, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH022863 | GA | Primary |
| Pharmacist | 183500000X | 16525 | LA |
Addresses
Primary practice location
4765 Redan Rd
Stone Mountain, GA 30088-4550
Mailing address
1400 Herrington Rd
Apt 10201
Lawrenceville, GA 30044-2280
Phone (504) 669-6029
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 |
|---|---|---|---|
| RPH022863 | GA | MD | Pharmacist |
| 16525 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
-
- Pharmacy
- Stone Mountain, GA
- NPI 1538290135
-
- Pharmacy
- Longview, TX
- NPI 1629956545
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": "1316649600000",
"number": "1225311558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 HERRINGTON RD",
"address_2": "APT 10201",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300442280",
"telephone_number": "504-669-6029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4765 REDAN RD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300884550",
"telephone_number": "404-299-5322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH022863",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "16525",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.