Individual provider Active NPI

Jeeyeon Shon, PHARMD

  • Pharmacist
  • Rockville, MD
National Provider Identifier
1336740430
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27515 Issued in MD
Practice address
9719 Traville Gateway Dr
Rockville, MD 20850-7408
Phone
(301) 315-1461
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27515 MD Primary

Addresses

Primary practice location

9719 Traville Gateway Dr
Rockville, MD 20850-7408

Mailing address

9719 Traville Gateway Dr
Rockville, MD 20850-7408
Phone (301) 315-1461

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
27515MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Giant of Maryland LLC PastSince Nov 8, 2020 Accepting new patients
Giant of Maryland LLC PastSince Nov 8, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1336740430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9719 TRAVILLE GATEWAY DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507408",
            "telephone_number": "301-315-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9719 TRAVILLE GATEWAY DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507408",
            "telephone_number": "301-315-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHON",
        "first_name": "JEEYEON",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "27515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.