Active NPI
Rod Shafer, R.PH.
- Pharmacist
- Mesa, AZ
National Provider Identifier
1235134826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S018200
- Practice address
- 435 S Ellsworth Rd
Mesa, AZ 85208-2305 - Phone
- (480) 380-1005
- NPI assigned
- Jun 20, 2005
- Last updated
- Feb 22, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00010359 | WA | |
| Pharmacist | 183500000X | S018200 | AZ | Primary |
| Pharmacist | 183500000X | 49642 | TX |
Addresses
Primary practice location
435 S Ellsworth Rd
Mesa, AZ 85208-2305
Mailing address
2361 N Higley Rd
Mesa, AZ 85215-2519
Phone (916) 802-9666
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 |
|---|---|---|---|
| S018200 | AZ | MD | Pharmacist |
| 49642 | TX | MD | Pharmacist |
| PH00010359 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1235134826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2361 N HIGLEY RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852152519",
"telephone_number": "916-802-9666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 S ELLSWORTH RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852082305",
"telephone_number": "480-380-1005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "ROD",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00010359",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S018200",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "49642",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.