Individual provider Active NPI

Shelby Marie Pandy Willis, PHARMD., MBA

  • Pharmacist
  • Chardon, OH
National Provider Identifier
1558250688
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03445508 Issued in OH
Practice address
13207 Ravenna Rd
Chardon, OH 44024-7032
Phone
(440) 285-2983
NPI assigned
Jul 2, 2025
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03445508 OH Primary

Addresses

Primary practice location

13207 Ravenna Rd
Chardon, OH 44024-7032

Mailing address

129 S Cedar St
Geneva, OH 44041-1657
Phone (440) 228-9724

Other practice location 1

755 S Broadway
Geneva, OH 44041-1916
Phone (440) 466-3005

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
Master of Business Administration, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03445508OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Tamarkin Company Past Accepting new patients
The Tamarkin Company Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1558250688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S CEDAR ST",
            "city": "GENEVA",
            "state": "OH",
            "postal_code": "440411657",
            "telephone_number": "440-228-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13207 RAVENNA RD",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440247032",
            "telephone_number": "440-285-2983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "755 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "OH",
            "postal_code": "440411916",
            "country_code": "US",
            "telephone_number": "440-466-3005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDY WILLIS",
        "first_name": "SHELBY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD., MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03445508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.