Active NPI
Jean Ross Shaw
- Pharmacist
- Philadelphia, MS
National Provider Identifier
1487733390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- N/A
- Practice address
- 584 E Main St
Suite8-a
Philadelphia, MS 39350-2342 - Phone
- (601) 656-5477
- Fax
- (601) 650-9882
- NPI assigned
- Nov 2, 2006
- Last updated
- Apr 25, 2008
- Sex
- Female
- 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 | N/A | MS | Primary |
Addresses
Primary practice location
584 E Main St
Suite8-a
Philadelphia, MS 39350-2342
Mailing address
12401 Highway 491 S
Union, MS 39365-8540
Phone (601) 656-5477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0040112 | Medicaid | MS |
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 |
|---|---|---|---|
| N/A | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209081600000",
"number": "1487733390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12401 HIGHWAY 491 S",
"city": "UNION",
"state": "MS",
"postal_code": "393658540",
"telephone_number": "601-656-5477",
"fax_number": "601-650-9882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "584 E MAIN ST",
"address_2": "SUITE8-A",
"city": "PHILADELPHIA",
"state": "MS",
"postal_code": "393502342",
"telephone_number": "601-656-5477",
"fax_number": "601-650-9882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "JEAN",
"middle_name": "ROSS",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2008-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "N/A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0040112",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, MS
- Rush Medical Group of Newton, PA (Rush Medical Group of Newton-Philadelphia)
- James Roy Sanderson, SURGICAL ASSTANT
- Rachael Reed Scarbrough, LCSW
- Serenity Comfort Home Care
- Serenity Hospice Care, LLC
- Emily Shepherd, RD, LD
- Thomas Shoffner, LPC
- Shouted Silence Services, LLC (The Anchor Clinic)
- Carrie Shrock-Haggard
- Michael B. Shrock, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.