Individual provider Active NPI

Kirat Shahiwala, PHARM.D., BSPHARM

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Burleson, TX
National Provider Identifier
1275900128
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
60393 Issued in TX
Practice address
12333 Bear PLZ Ste 100
Burleson, TX 76028-0215
Phone
(817) 789-4099
Fax
(800) 616-4641
NPI assigned
Aug 26, 2015
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 5302040455 MI
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 60393 TX Primary

Addresses

Primary practice location

12333 Bear PLZ Ste 100
Burleson, TX 76028-0215

Mailing address

12333 Bear PLZ Ste 100
Burleson, TX 76028-0215
Phone (817) 789-4099

Other practice location 1

4740 W Mockingbird Ln # 100B
Dallas, TX 75209-5208
Phone (214) 350-2900

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
5302040455MIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
60393TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Blue Holdings, LLC CurrentSince Aug 18, 2024 Accepting new patients
Powerhouse Pharmacy RX LLC Current Accepting new patients
Ocean Blue Holdings, LLC CurrentSince Aug 18, 2024 Accepting new patients
Powerhouse Pharmacy RX LLC CurrentSince Aug 1, 2019 Accepting new patients

Locations

12333 Bear Plz
Ste 100
Burleson, TX 76028
Phone (682) 224-0888

2726 W Mockingbird Ln
Dallas, TX 75235
Phone (214) 350-2900

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1275900128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12333 BEAR PLZ STE 100",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280215",
            "telephone_number": "817-789-4099",
            "fax_number": "800-616-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12333 BEAR PLZ STE 100",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280215",
            "telephone_number": "817-789-4099",
            "fax_number": "800-616-4641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4740 W Mockingbird Ln # 100B",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752095208",
            "country_code": "US",
            "telephone_number": "214-350-2900",
            "fax_number": "214-350-2904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHIWALA",
        "first_name": "KIRAT",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., BSPHARM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MI",
            "license": "5302040455",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "60393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.