Active NPI
Shannon Berry
- Pharmacist
- Belton, MO
National Provider Identifier
1679174643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2015025621
- Practice address
- 1307 E North Ave
Belton, MO 64012-5109 - Phone
- (816) 318-0404
- Fax
- (816) 318-0446
- NPI assigned
- Nov 5, 2020
- Last updated
- Apr 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2015025621 | MO | Primary |
Addresses
Primary practice location
1307 E North Ave
Belton, MO 64012-5109
Mailing address
104 Frederick LN
Raymore, MO 64083-9738
Phone (816) 914-7533
Other practice location 1
1712 E Ohio St
Clinton, MO 64735-2402
Phone (660) 890-2587
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2015025621 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648771200000",
"number": "1679174643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 FREDERICK LN",
"city": "RAYMORE",
"state": "MO",
"postal_code": "640839738",
"telephone_number": "816-914-7533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 E NORTH AVE",
"city": "BELTON",
"state": "MO",
"postal_code": "640125109",
"telephone_number": "816-318-0404",
"fax_number": "816-318-0446"
}
],
"practiceLocations": [
{
"address_1": "1712 E Ohio St",
"address_purpose": "LOCATION",
"city": "Clinton",
"state": "MO",
"postal_code": "647352402",
"country_code": "US",
"telephone_number": "660-890-2587",
"fax_number": "660-885-4738",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERRY",
"first_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-05",
"last_updated": "2022-04-01",
"certification_date": "2022-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2015025621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belton, MO
- Beautiful Savior Home (Beautiul Savior Lutheran Home)
- Belton Dental, LLC (Belton Healthy Smiles)
- Belton Family Practice Clinic LLC
- Belton School District
- Belton Senior Living Operator, LLC (Carnegie Village)
- Timothy L Blackburn, M.D.
- Frank B Blacknall, DDS
- Bleauridge Nursing and Rehab LLC (Beautiful Savior Nursing Home)
- Bleauridge Nursing and Rehab LLC
- Kent A Bogner, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.