Jill Renee Shackelford, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302031520 Issued in MI

Practice address

1280 Walton Blvd
Rochester Hills, MI 48307-6900

Phone

(248) 608-0643

NPI assigned

Jun 15, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1437444742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 WALTON BLVD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076900",
            "telephone_number": "248-608-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 WALTON BLVD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076900",
            "telephone_number": "248-608-0643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Monument Rd",
            "address_2": "T-0645",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322256429",
            "country_code": "US",
            "telephone_number": "904-722-8573",
            "fax_number": "904-722-8573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "JILL",
        "middle_name": "RENEE",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS34998",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302031520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rivonda Sesi, PA-C
• Annu Khindri Seth, MS, OTR/L
• Pauline Kay Setser, MA LLPC NCC
• Buffie Lynn Severns, CNM
• Sarah Neil Shaba, PA-C
• Shafiq Alam MD PC
• Khushboo R Shah
• Tejal Shah, PHARMACIST
• Ahmad Bahjat Shahbandar, MD
• Shahrokh H Mansoori MD PC

• Pharmacist in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.