Active NPI
Leonard Shetler
- Pharmacist
- Lagrange, IN
National Provider Identifier
1265037568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26016450A
- Practice address
- CVS Pharmacy
975 N 00 Ew
Lagrange, IN 46761-4676 - Phone
- (260) 463-2583
- NPI assigned
- Dec 3, 2020
- 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 | 26016450A | IN | Primary |
Addresses
Primary practice location
CVS Pharmacy
975 N 00 Ew
Lagrange, IN 46761-4676
Mailing address
57271 County Road 23
Goshen, IN 46528-7097
Phone (574) 536-6260
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26016450A | IN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1265037568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57271 COUNTY ROAD 23",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465287097",
"telephone_number": "574-536-6260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CVS PHARMACY",
"address_2": "975 N 00 EW",
"city": "LAGRANGE",
"state": "IN",
"postal_code": "467614676",
"telephone_number": "260-463-2583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHETLER",
"first_name": "LEONARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26016450A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.