Individual provider Active NPI

Shane Joseph Daugherty, RPH

  • Pharmacist
  • New Stanton, PA
National Provider Identifier
1396227880
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP452360 Issued in PA
Practice address
144 Post Avenue
New Stanton, PA 15672
Phone
(724) 925-9810
NPI assigned
Aug 31, 2018
Last updated
Dec 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP452360 PA Primary

Addresses

Primary practice location

144 Post Avenue
New Stanton, PA 15672

Mailing address

PO Box 515
New Stanton, PA 15672-0515
Phone (724) 925-9810

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP452360PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ristway Inc CurrentSince Dec 10, 2023 Accepting new patients
Ristway Inc CurrentSince Dec 10, 2023 Accepting new patients

Locations

144 Post Ave
New Stanton, PA 15672
Phone (724) 925-9810

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1396227880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515",
            "city": "NEW STANTON",
            "state": "PA",
            "postal_code": "156720515",
            "telephone_number": "724-925-9810",
            "fax_number": "724-925-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 POST AVENUE",
            "city": "NEW STANTON",
            "state": "PA",
            "postal_code": "15672",
            "telephone_number": "724-925-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "SHANE",
        "middle_name": "JOSEPH",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-31",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP452360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Stanton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.