Shannon Kathleen Gradert, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH033484 Issued in GA

Practice address

1625 Pleasant Hill Rd Ste 200
Duluth, GA 30096-5863

Phone

(770) 806-2787

Fax

(770) 638-7642

NPI assigned

May 18, 2022

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Shannon Kathleen Halloran Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia CVS Pharmacy L.L.C

  dba CVS Pharmacy #11017

  • Pharmacy
  • Pooler, GA
  • NPI 1578009130
  NPD (past)
• Publix Super Markets Inc

  dba Publix Pharmacy #2107

  • Community/Retail Pharmacy
  • Winter Haven, FL
  • NPI 1760356380
  NPD (past)

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1669119814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 CARRIAGE GATE DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 PLEASANT HILL RD STE 200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965863",
            "telephone_number": "770-806-2787",
            "fax_number": "770-638-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADERT",
        "first_name": "SHANNON",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH033484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "HALLORAN",
            "middle_name": "KATHLEEN",
            "prefix": "DR.",
            "credential": "PHARMD, RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ramani Gowducheruvu, DDS
• Eva Florence Goyette, D.O.
• Grace Acupuncture & Oriental Medicine
• Grace Medical and Wellness Center, LLC
• Robert Davis Grace, D.C.
• Sean P Grady, DDS
• John C Graeber Jr., CAA
• Elena Granados-Barron
• Khaleal Granger
• Julie Ann Grant, PTA

• Pharmacist in Duluth, GA
• Providers in Duluth, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.