Individual provider Active NPI

Shelby Lanese, PHARMD

  • Pharmacist
  • Wallingford, CT
National Provider Identifier
1649922840
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15620 Issued in CT
Practice address
1163 Old Colony Rd Unit 19
Wallingford, CT 06492-1792
Phone
(203) 231-6897
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15620 CT Primary

Addresses

Primary practice location

1163 Old Colony Rd Unit 19
Wallingford, CT 06492-1792

Mailing address

1163 Old Colony Rd Unit 19
Wallingford, CT 06492-1792
Phone (203) 231-6897

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

LicenseStateTypeSpecialty
15620CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1649922840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 OLD COLONY RD UNIT 19",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921792",
            "telephone_number": "203-231-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 OLD COLONY RD UNIT 19",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921792",
            "telephone_number": "203-231-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANESE",
        "first_name": "SHELBY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "15620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.