Individual provider Active NPI

Shaman Poulos, PHARMD

  • Pharmacist
  • Nashville, TN
National Provider Identifier
1326525569
Registry record updated Nov 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
42193 Issued in TN
Practice address
6614 Charlotte Pike
Nashville, TN 37209-4202
Phone
(615) 352-1203
NPI assigned
Jul 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42193 TN Primary

Addresses

Primary practice location

6614 Charlotte Pike
Nashville, TN 37209-4202

Mailing address

8028 Highway 100
Nashville, TN 37221-4212
Phone (615) 673-2756

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
42193TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Tennessee, LLC PastSince Nov 17, 2019 Accepting new patients
Publix Tennessee LLC PastSince Nov 17, 2019 Accepting new patients
Publix Tennessee LLC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573257600000",
    "number": "1326525569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8028 HIGHWAY 100",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372214212",
            "telephone_number": "615-673-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 CHARLOTTE PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372094202",
            "telephone_number": "615-352-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "SHAMAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2019-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "42193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2019; 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.