Shelly Dortch Oswalt, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

E08639 Issued in MS

Practice address

2461 5TH St N
Columbus, MS 39705-2005

Phone

(662) 327-0079

NPI assigned

Aug 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1346851375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LAKEOVER DR W",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397029709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2461 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052005",
            "telephone_number": "662-327-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSWALT",
        "first_name": "SHELLY",
        "middle_name": "DORTCH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E08639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rxm.11599@store.walgreens.com",
            "affiliation": "N",
            "address_1": "2461 5th St N",
            "city": "Columbus",
            "state": "MS",
            "country_code": "US",
            "postal_code": "397052005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Columbus, MS
• Providers in Columbus, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.