Active NPI
Shannon G Whitaker, RPH
- Pharmacist
- Diberville, MS
National Provider Identifier
1225324577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8370
- Practice address
- 4031 Popps Ferry Rd
#A
Diberville, MS 39540-2367 - Phone
- (228) 392-7310
- NPI assigned
- Jun 24, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 8370 | MS | Primary |
Addresses
Primary practice location
4031 Popps Ferry Rd
#A
Diberville, MS 39540-2367
Mailing address
6721 Washington Ave
Apt 7B
Ocean Springs, MS 39564-2144
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8370 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308873600000",
"number": "1225324577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6721 WASHINGTON AVE",
"address_2": "APT 7B",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395642144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4031 POPPS FERRY RD",
"address_2": "#A",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395402367",
"telephone_number": "228-392-7310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITAKER",
"first_name": "SHANNON",
"middle_name": "G",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-24",
"last_updated": "2011-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "8370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diberville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.