Shade Wilson Honeycutt

Primary specialty

PharmacistTaxonomy code 183500000X

License

0201003093 Issued in VA

Practice address

211 Providence Rd Ste 15
Chesapeake, VA 23325-4687

Phone

(757) 424-2240

Fax

(757) 424-3632

NPI assigned

Feb 19, 2009

Last updated

Feb 19, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1467691113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PROVIDENCE RD STE 15",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233254687",
            "telephone_number": "757-424-2240",
            "fax_number": "757-424-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PROVIDENCE RD STE 15",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233254687",
            "telephone_number": "757-424-2240",
            "fax_number": "757-424-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONEYCUTT",
        "first_name": "SHADE",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0201003093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008518688",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.