Jordan Ian Shenk, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

S021728 Issued in AZ

Practice address

6767 E Broadway Blvd
Tucson, AZ 85710-4016

Phone

(520) 290-0958

NPI assigned

Aug 19, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1235505645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102806",
            "telephone_number": "520-290-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857104016",
            "telephone_number": "520-290-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENK",
        "first_name": "JORDAN",
        "middle_name": "IAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S021728",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "36399",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "S021728",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea C Shelton, DNP, APRN, CNM
• Karen Shelton, APN
• Robert Victor Shelton, DDS
• Jerry Yue Shen, MD
• Wei Shen, M.D.
• Linda J Shenk, MS, CCC-SLP
• Suresh Kumar Shenkeshi
• Sundeep Shenoy, M.D.
• David Shepard, LMT
• Robin Shepard, FNP-BC

• Pharmacist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.