Active NPI
Tushar Shah
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Livonia, MI
National Provider Identifier
1609412485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 5302038144
- Practice address
- 30935 Five Mile Rd
Livonia, MI 48154-3600 - Phone
- (734) 422-3784
- NPI assigned
- Nov 26, 2019
- Last updated
- Nov 26, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5302038144 | MI | Primary |
Addresses
Primary practice location
30935 Five Mile Rd
Livonia, MI 48154-3600
Mailing address
30935 Five Mile Rd
Livonia, MI 48154-3600
Phone (734) 422-3784
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038144 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Co of Michigan | Past | Accepting new patients | |
| Kroger Co of Michigan | 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": "1574726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1609412485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30935 FIVE MILE RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481543600",
"telephone_number": "734-422-3784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30935 FIVE MILE RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481543600",
"telephone_number": "734-422-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "TUSHAR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-26",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MI",
"license": "5302038144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.