Individual provider Active NPI

Akil Joseph Shambourger, PHARMD

  • Pharmacist
  • Edgewood, MD
National Provider Identifier
1235618612
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25859 Issued in MD
Practice address
1930 Pulaski Hwy
Edgewood, MD 21040-1612
Phone
(410) 671-6568
Fax
(410) 676-2648
NPI assigned
Aug 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25859 MD Primary

Addresses

Primary practice location

1930 Pulaski Hwy
Edgewood, MD 21040-1612

Mailing address

1930 Pulaski Hwy
Edgewood, MD 21040-1612
Phone (410) 671-6568

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
25859MDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1235618612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 PULASKI HWY",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401612",
            "telephone_number": "410-671-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 PULASKI HWY",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401612",
            "telephone_number": "410-671-6568",
            "fax_number": "410-676-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBOURGER",
        "first_name": "AKIL",
        "middle_name": "JOSEPH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "25859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.