NPIMap

Individual provider Active NPI

Peter Shenouda

  • Pharmacist
  • Bakersfield, CA
National Provider Identifier
1417359217
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
63807 Issued in CA
Practice address
5075 Gosford Rd
Bakersfield, CA 93313-4993
Phone
(661) 282-2144
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 63807 CA Primary

Addresses

Primary practice location

5075 Gosford Rd
Bakersfield, CA 93313-4993

Mailing address

10601 Harpenden Ave
Bakersfield, CA 93311-3519
Phone (661) 706-7143

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carepharm Pharmacy 2 Current Accepting new patients
Carepharm Pharmacy Current Accepting new patients
Carepharm Pharmacy Current Accepting new patients
Walmart Inc. Past Accepting new patients

Locations

4700 Panama Ln
Unit 116
Bakersfield, CA 93313
Phone (661) 706-7143

Organizations & group practices 4

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1417359217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 HARPENDEN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113519",
            "telephone_number": "661-706-7143",
            "fax_number": "661-282-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 GOSFORD RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933134993",
            "telephone_number": "661-282-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOUDA",
        "first_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "63807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.