Individual provider Active NPI

Brooke Shaner, PHARMD

  • Pharmacist
  • Raleigh, NC
National Provider Identifier
1235584665
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25779 Issued in NC
Practice address
3205 Avent Ferry Rd
Raleigh, NC 27606-2720
Phone
(919) 833-5531
Fax
(919) 839-1859
NPI assigned
May 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25779 NC Primary

Addresses

Primary practice location

3205 Avent Ferry Rd
Raleigh, NC 27606-2720

Mailing address

3205 Avent Ferry Rd
Raleigh, NC 27606-2720
Phone (919) 833-5531

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
25779NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince May 1, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1235584665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 AVENT FERRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062720",
            "telephone_number": "919-833-5531",
            "fax_number": "919-839-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 AVENT FERRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062720",
            "telephone_number": "919-833-5531",
            "fax_number": "919-839-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANER",
        "first_name": "BROOKE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "25779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.