Active NPI
Shiloh Wedermyer, PHARM.D.
- Pharmacist
- South Bend, IN
National Provider Identifier
1609462639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26028410A
- Practice address
- 51467 In-933
South Bend, IN 46637 - Phone
- (574) 243-0904
- NPI assigned
- Dec 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-109618 | KS | |
| Pharmacist | 183500000X | 26028410A | IN | Primary |
Addresses
Primary practice location
51467 In-933
South Bend, IN 46637
Mailing address
321 S Main St Apt 203
South Bend, IN 46601-2232
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26028410A | IN | MD | Pharmacist |
| 1-109618 | KS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608336000000",
"number": "1609462639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 S MAIN ST APT 203",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466012232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51467 IN-933",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "46637",
"telephone_number": "574-243-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDERMYER",
"first_name": "SHILOH",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-14",
"last_updated": "2020-12-19",
"certification_date": "2020-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-109618",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26028410A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.