Active NPI
Shelby Song
- Pharmacist
- Worcester, MA
National Provider Identifier
1285236844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH239000
- Practice address
- 220 Grafton St
Worcester, MA 01604-4906 - Phone
- (508) 755-4196
- NPI assigned
- Nov 9, 2020
- Last updated
- Nov 9, 2020
- Sex
- Female
- 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 | PH239000 | MA | Primary |
Addresses
Primary practice location
220 Grafton St
Worcester, MA 01604-4906
Mailing address
220 Grafton St
Worcester, MA 01604-4906
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 |
|---|---|---|---|
| PH239000 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
220 Grafton St
Worcester, MA 01604
Phone (508) 755-4196
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, 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": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1285236844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 GRAFTON ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016044906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 GRAFTON ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016044906",
"telephone_number": "508-755-4196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "SHELBY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-09",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH239000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.