Active NPI
Jon Michael Shelly, RPH
- Pharmacist
- North Canton, OH
National Provider Identifier
1437431848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03209239
- Practice address
- 1000 S Main St
North Canton, OH 44720-3628 - Phone
- (330) 497-8316
- Fax
- (330) 494-8236
- NPI assigned
- Sep 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 03209239 | OH | Primary |
Addresses
Primary practice location
1000 S Main St
North Canton, OH 44720-3628
Mailing address
1000 S Main St
North Canton, OH 44720-3628
Phone (330) 497-8316
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 |
|---|---|---|---|
| 03209239 | OH | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315785600000",
"number": "1437431848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 S MAIN ST",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447203628",
"telephone_number": "330-497-8316",
"fax_number": "330-494-8236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S MAIN ST",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447203628",
"telephone_number": "330-497-8316",
"fax_number": "330-494-8236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLY",
"first_name": "JON",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-12",
"last_updated": "2011-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03209239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.