Active NPI
Karla Shanesy
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1417630831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP450387
- Practice address
- 4055-89 Market Street
Philadelphia, PA 19146 - Phone
- (215) 382-4260
- NPI assigned
- Aug 11, 2023
- Sex
- Female
- 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 | RP450387 | PA | Primary |
Addresses
Primary practice location
4055-89 Market Street
Philadelphia, PA 19146
Mailing address
1500 S 25TH St
Philadelphia, PA 19146-4401
Phone (304) 780-9037
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP450387 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1417630831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S 25TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191464401",
"telephone_number": "304-780-9037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055-89 MARKET STREET",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19146",
"telephone_number": "215-382-4260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANESY",
"first_name": "KARLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-11",
"last_updated": "2023-08-11",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP450387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.