Active NPI
David R. Shore, RPH.
- Pharmacist
- Johns Creek, GA
National Provider Identifier
1407136047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH014847
- Practice address
- 4395 Kimball Bridge Rd
Johns Creek, GA 30022-4409 - Phone
- (678) 566-0422
- Fax
- (678) 566-3112
- NPI assigned
- Aug 26, 2011
- 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 | RPH014847 | GA | Primary |
Addresses
Primary practice location
4395 Kimball Bridge Rd
Johns Creek, GA 30022-4409
Mailing address
4395 Kimball Bridge Rd
Johns Creek, GA 30022-4409
Phone (678) 566-0422
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH014847 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1314316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1407136047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4395 KIMBALL BRIDGE RD",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300224409",
"telephone_number": "678-566-0422",
"fax_number": "678-566-3112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4395 KIMBALL BRIDGE RD",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300224409",
"telephone_number": "678-566-0422",
"fax_number": "678-566-3112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORE",
"first_name": "DAVID",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-26",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH014847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Creek, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.