Individual provider Active NPI

Ashish K Shah, B.S. PHARMACY

  • Pharmacist
  • Lake Wales, FL
National Provider Identifier
1639296379
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS37285 Issued in FL
Practice address
1903 State Road 60 E
Lake Wales, FL 33853-4329
Phone
(863) 676-9496
Fax
(863) 678-1829
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS37285 FL Primary
Pharmacist 183500000X 5302034040 MI

Addresses

Primary practice location

1903 State Road 60 E
Lake Wales, FL 33853-4329

Mailing address

6123 Mission Dr
Lakeland, FL 33813-0816
Phone (863) 647-9028

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
PS37285FLMDPharmacist
5302034040MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639296379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6123 MISSION DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338130816",
            "telephone_number": "863-647-9028",
            "fax_number": "863-678-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534329",
            "telephone_number": "863-676-9496",
            "fax_number": "863-678-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ASHISH",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "B.S. PHARMACY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS37285",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302034040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

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.