Active NPI
Kevin Shah, PHARM.D
- Pharmacist
- West Bloomfield, MI
National Provider Identifier
1386230597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051295863
- Practice address
- 4901 Haggerty Rd
West Bloomfield, MI 48323-3903 - Phone
- (630) 450-5793
- NPI assigned
- Dec 13, 2020
- Last updated
- Dec 13, 2020
- 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 | 051295863 | IL | Primary |
Addresses
Primary practice location
4901 Haggerty Rd
West Bloomfield, MI 48323-3903
Mailing address
1451 Chapleau Dr
Ann Arbor, MI 48103-8878
Phone (630) 450-5793
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 |
|---|---|---|---|
| 051295863 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607817600000",
"number": "1386230597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1451 CHAPLEAU DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481038878",
"telephone_number": "630-450-5793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 HAGGERTY RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483233903",
"telephone_number": "630-450-5793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "KEVIN",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-13",
"last_updated": "2020-12-13",
"certification_date": "2020-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051295863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.