Individual provider Active NPI

Clifton Eugene Shaw, DPH

  • Pharmacist
  • Mobile, AL
National Provider Identifier
1629288717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7347 Issued in AL
Practice address
6400 Airport Blvd
Mobile, AL 36608-3702
Phone
(251) 380-3188
Fax
(251) 344-5819
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7347 AL Primary

Addresses

Primary practice location

6400 Airport Blvd
Mobile, AL 36608-3702

Mailing address

6755 Mauvilla Dr W
Eight Mile, AL 36613-9351
Phone (251) 422-2500

Other identifiers 1

IdentifierTypeStateIssuer
7347OtherALPHARMACIST REGISTRATION

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
7347ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629288717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6755 MAUVILLA DR W",
            "city": "EIGHT MILE",
            "state": "AL",
            "postal_code": "366139351",
            "telephone_number": "251-422-2500",
            "fax_number": "251-679-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083702",
            "telephone_number": "251-380-3188",
            "fax_number": "251-344-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CLIFTON",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "7347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST REGISTRATION",
            "identifier": "7347",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.