NPIMap

Individual provider Active NPI

Jared M Shayka, PHARMD

  • Pharmacist
  • Clifford, PA
National Provider Identifier
1487894705
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP442680 Issued in PA
Practice address
1866 State Route 106
Suite 11
Clifford, PA 18413
Phone
(570) 222-7500
NPI assigned
Feb 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP442680 PA Primary
Pharmacist 183500000X 18956 MD

Addresses

Primary practice location

1866 State Route 106
Suite 11
Clifford, PA 18413

Mailing address

11 Mountain View Plaza
P.O. Box 189
Clifford, PA 18413
Phone (570) 222-7500

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
18956MDMDClinical Social Worker
RP442680PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Endless Mountains Pharmacy Inc Past Accepting new patients

Organizations & group practices 1

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": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1487894705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MOUNTAIN VIEW PLAZA",
            "address_2": "P.O. BOX 189",
            "city": "CLIFFORD",
            "state": "PA",
            "postal_code": "18413",
            "telephone_number": "570-222-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 STATE ROUTE 106",
            "address_2": "SUITE 11",
            "city": "CLIFFORD",
            "state": "PA",
            "postal_code": "18413",
            "telephone_number": "570-222-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYKA",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP442680",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "18956",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.