Individual provider Active NPI

Sarah Jordan Shockley, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Minneapolis, MN
National Provider Identifier
1528612017
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
124464 Issued in MN
Practice address
2512 S 7TH St FL 3
Minneapolis, MN 55454-1404
Phone
(612) 672-4061
NPI assigned
Aug 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 124464 MN Primary

Addresses

Primary practice location

2512 S 7TH St FL 3
Minneapolis, MN 55454-1404

Mailing address

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8860

Other practice location 1

909 Fulton St SE Fl 3
Minneapolis, MN 55455-4800
Phone (612) 672-4061

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
124464MNMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1528612017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 CENTRAL PARK VILLAGE DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551217707",
            "telephone_number": "651-406-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 S 7TH ST FL 3",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541404",
            "telephone_number": "612-672-4061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Fulton St SE Fl 3",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554554800",
            "country_code": "US",
            "telephone_number": "612-672-4061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "SARAH",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "124464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.