Individual provider Active NPI

Palak P Shah

  • Pharmacist
  • Xenia, OH
National Provider Identifier
1619257136
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03228118 Issued in OH
Practice address
537 W Main St
Xenia, OH 45385-2811
Phone
(937) 376-0631
Fax
(937) 376-0751
NPI assigned
Aug 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03228118 OH Primary

Addresses

Primary practice location

537 W Main St
Xenia, OH 45385-2811

Mailing address

537 W Main St
Xenia, OH 45385-2811
Phone (937) 376-0631

Other practice location 1

2269 N Fairfield Rd
Beavercreek, OH 45431-2526
Phone (937) 320-9112

Other practice location 2

6485 Wilmington Pike
Dayton, OH 45459-7110
Phone (937) 433-5314

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
03228118OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Nov 12, 2023 Accepting new patients
Walgreen Co PastSince Apr 1, 2022 Accepting new patients
Walgreen Co PastSince Jun 1, 2022 Accepting new patients
Walgreen Co PastSince Apr 1, 2022 Accepting new patients

Locations

537 W Main St
Xenia, OH 45385
Phone (937) 376-0631

Organizations & group practices 4

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": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1619257136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 W MAIN ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852811",
            "telephone_number": "937-376-0631",
            "fax_number": "937-376-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 W MAIN ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852811",
            "telephone_number": "937-376-0631",
            "fax_number": "937-376-0751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2269 N Fairfield Rd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454312526",
            "country_code": "US",
            "telephone_number": "937-320-9112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6485 Wilmington Pike",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454597110",
            "country_code": "US",
            "telephone_number": "937-433-5314",
            "fax_number": "937-433-7437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PALAK",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-29",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03228118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.