Shawn Keith Peterson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS61539 Issued in FL

Practice address

4525 Gunn Hwy
Tampa, FL 33624-6311

Phone

(813) 261-6086

NPI assigned

Mar 18, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1437735776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9317 CERULEAN DR APT 305",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784764",
            "telephone_number": "860-608-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336246311",
            "telephone_number": "813-261-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHAWN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS61539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Connexus",
            "affiliation": "N",
            "endpointDescription": "walmart pharmacy connexus  system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4525 Gunn Hwy",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336246311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Peterson
• Lauren Ashley Peterson, M.A., BCBA
• Patricia Peterson
• Pete Franklin Peterson, MD
• Ronald Eugene Peterson Jr.
• Terita Peterson, R.PH
• Zachary Peterson, PT, DPT
• Lovelie Petit Frere
• Paula Petit-Frere, BCBA
• Romilla Petit-Homme, MA

• Pharmacist in Tampa, FL
• Providers in Tampa, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.