Active NPI
Shelby Miller II
- Pharmacist
- Kentwood, LA
National Provider Identifier
1366812901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.021122
- Practice address
- 210 Avenue G
Kentwood, LA 70444-2804 - Phone
- (985) 229-2501
- Fax
- (985) 229-7561
- NPI assigned
- Sep 25, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.021122 | LA | Primary |
Addresses
Primary practice location
210 Avenue G
Kentwood, LA 70444-2804
Mailing address
210 Avenue G
Kentwood, LA 70444-2804
Phone (985) 229-2501
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 |
|---|---|---|---|
| PST.021122 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443139200000",
"number": "1366812901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 AVENUE G",
"city": "KENTWOOD",
"state": "LA",
"postal_code": "704442804",
"telephone_number": "985-229-2501",
"fax_number": "985-229-7561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 AVENUE G",
"city": "KENTWOOD",
"state": "LA",
"postal_code": "704442804",
"telephone_number": "985-229-2501",
"fax_number": "985-229-7561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SHELBY",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-25",
"last_updated": "2015-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.021122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.