Individual provider Active NPI

Hayley Brooke Shepherd

  • Pharmacist
  • Elkview, WV
National Provider Identifier
1336806033
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0012712 Issued in WV
Practice address
8 Elk PLZ
Elkview, WV 25071-9602
Phone
(304) 965-1111
NPI assigned
Nov 17, 2021
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202220094 VA
Pharmacist 183500000X RP0012712 WV Primary

Addresses

Primary practice location

8 Elk PLZ
Elkview, WV 25071-9602

Mailing address

12 Williamton Grove Dr
Elkview, WV 25071-7422
Phone (304) 545-9782

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

LicenseStateTypeSpecialty
0202220094VAMDPharmacist
RP0012712WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1336806033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WILLIAMTON GROVE DR",
            "city": "ELKVIEW",
            "state": "WV",
            "postal_code": "250717422",
            "telephone_number": "304-545-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 ELK PLZ",
            "city": "ELKVIEW",
            "state": "WV",
            "postal_code": "250719602",
            "telephone_number": "304-965-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "HAYLEY",
        "middle_name": "BROOKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202220094",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0012712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkview, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.