Individual provider Active NPI

William J Shafer

  • Pharmacist
  • Lake Orion, MI
National Provider Identifier
1609412733
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302033095 Issued in MI
Practice address
3097 S Baldwin Rd
Lake Orion, MI 48359-1028
Phone
(248) 393-4573
Fax
(248) 393-4583
NPI assigned
Nov 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302033095 MI Primary

Addresses

Primary practice location

3097 S Baldwin Rd
Lake Orion, MI 48359-1028

Mailing address

2658 Pebble Beach Dr
Oakland, MI 48363-2449
Phone (248) 229-4042

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

LicenseStateTypeSpecialty
5302033095MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Co of Michigan Past Accepting new patients
Kroger Co of Michigan PastSince Dec 1, 2019 Accepting new patients
Kroger Co of Michigan PastSince Dec 1, 2019 Accepting new patients

Organizations & group practices 3

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": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1609412733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2658 PEBBLE BEACH DR",
            "city": "OAKLAND",
            "state": "MI",
            "postal_code": "483632449",
            "telephone_number": "248-229-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 S BALDWIN RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483591028",
            "telephone_number": "248-393-4573",
            "fax_number": "248-393-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-25",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302033095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Orion, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.