Active NPI
Kevin Shores, PHARMD
- Pharmacist
- Acworth, GA
National Provider Identifier
1376902569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH028991
- Practice address
- 3245 Cobb Pkwy NW
Acworth, GA 30101-3938 - Phone
- (770) 974-0936
- NPI assigned
- Feb 16, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH028991 | GA | Primary |
| Pharmacist | 183500000X | PS54508 | FL |
Addresses
Primary practice location
3245 Cobb Pkwy NW
Acworth, GA 30101-3938
Mailing address
3245 Cobb Pkwy NW
Acworth, GA 30101-3938
Phone (770) 974-0936
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS54508 | FL | MD | Pharmacist |
| RPH028991 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455580800000",
"number": "1376902569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 COBB PKWY NW",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301013938",
"telephone_number": "770-974-0936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3245 COBB PKWY NW",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301013938",
"telephone_number": "770-974-0936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORES",
"first_name": "KEVIN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-16",
"last_updated": "2016-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH028991",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS54508",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Acworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.