Individual provider Active NPI

David Reed Shakespeare, PHARM-D

  • Pharmacist
  • Kanab, UT
National Provider Identifier
1376130997
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4817479 Issued in UT
Practice address
176 W Center St
Kanab, UT 84741-3416
Phone
(356) 442-4184
Fax
(435) 644-2057
NPI assigned
Dec 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 4817479 UT Primary

Addresses

Primary practice location

176 W Center St
Kanab, UT 84741-3416

Mailing address

176 W Center St
Kanab, UT 84741-3416
Phone (356) 442-4184

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
4817479UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
DT Kenai Investment LLC CurrentSince Jan 3, 2021 Accepting new patients

Locations

176 W Center St
Kanab, UT 84741
Phone (356) 442-4184

Organizations & group practices 1

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": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1376130997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 W CENTER ST",
            "city": "KANAB",
            "state": "UT",
            "postal_code": "847413416",
            "telephone_number": "356-442-4184",
            "fax_number": "435-644-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 W CENTER ST",
            "city": "KANAB",
            "state": "UT",
            "postal_code": "847413416",
            "telephone_number": "356-442-4184",
            "fax_number": "435-644-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKESPEARE",
        "first_name": "DAVID",
        "middle_name": "REED",
        "credential": "PHARM-D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "4817479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kanab, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.