Active NPI
Deborah Jean Shaner Gates
- Pharmacy Technician
- Pooler, GA
National Provider Identifier
1306438247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- PHTC056411
- Practice address
- 500 Pooler Pkwy
Pooler, GA 31322-5171 - Phone
- (912) 748-5170
- NPI assigned
- Feb 10, 2021
- Last updated
- Feb 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | PHTC056411 | GA | Primary |
Addresses
Primary practice location
500 Pooler Pkwy
Pooler, GA 31322-5171
Mailing address
6409 Poinsett Way
Pooler, GA 31322-5522
Phone (540) 207-1588
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 |
|---|---|---|---|
| PHTC056411 | GA | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients |
Organizations & group practices 1
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": "1612915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1306438247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6409 POINSETT WAY",
"city": "POOLER",
"state": "GA",
"postal_code": "313225522",
"telephone_number": "540-207-1588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 POOLER PKWY",
"city": "POOLER",
"state": "GA",
"postal_code": "313225171",
"telephone_number": "912-748-5170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "DEBORAH",
"middle_name": "JEAN SHANER",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-10",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "GA",
"license": "PHTC056411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.