Shawn Patrick Nelson, PHARM. D

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH021377 Issued in GA

Practice address

12387 Yellow Bluff Dr
Jacksonville, FL 32226-2025

Phone

(904) 751-2744

Fax

(904) 751-7524

NPI assigned

Sep 13, 2011

Last updated

Sep 13, 2011By 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 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walgreen Co

  dba Walgreens 09479

  • Pharmacy
  • Jacksonville, FL
  • NPI 1003086380
  NPD (past)

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1497037782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12387 YELLOW BLUFF RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262025",
            "telephone_number": "904-751-2744",
            "fax_number": "904-751-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12387 YELLOW BLUFF DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262025",
            "telephone_number": "904-751-2744",
            "fax_number": "904-751-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHAWN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH021377",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40458",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nakita Nelson
• Remy Nelson, LMHC
• Samantha Nelson
• Samantha Nelson
• Shandel Nelson, CALLAWAY(MAIDEN)
• Valarie Nelson, MA
• Wendell Nelson
• Winifred Nelson, FNP-C
• Justin Nemelka
• Nemetz Dental Associates

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.