Individual provider Active NPI

Kevin Michael Shafer, RPH

  • Pharmacist
  • Philippi, WV
National Provider Identifier
1558919381
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0006193 Issued in WV
Practice address
440 S Main St
Philippi, WV 26416-0015
Phone
(304) 457-4233
NPI assigned
Aug 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP0006193 WV Primary

Addresses

Primary practice location

440 S Main St
Philippi, WV 26416-0015

Mailing address

1263 Briercliff Rd
Bridgeport, WV 26330-1303
Phone (304) 629-7718

Other practice location 1

204 Crim Ave
Belington, WV 26250
Phone (304) 823-1001

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP0006193WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Maces Pharmacy Inc Past Accepting new patients
Mace'S Pharmacy, Inc. PastSince Nov 10, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1558919381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 BRIERCLIFF RD",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301303",
            "telephone_number": "304-629-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 S MAIN ST",
            "city": "PHILIPPI",
            "state": "WV",
            "postal_code": "264160015",
            "telephone_number": "304-457-4233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Crim Ave",
            "address_purpose": "LOCATION",
            "city": "Belington",
            "state": "WV",
            "postal_code": "26250",
            "country_code": "US",
            "telephone_number": "304-823-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0006193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philippi, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.