Active NPI
Shantana Janae Fadeyi, R.PH
- Pharmacist
- Orlando, FL
National Provider Identifier
1699387456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS52981
- Practice address
- 4502 S Orange Blossom TRL
Orlando, FL 32839-1704 - Phone
- (407) 851-6040
- NPI assigned
- Aug 21, 2020
- Last updated
- Aug 21, 2020
- Sex
- Female
- Sole proprietor
- No
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 | PS52981 | FL | Primary |
Addresses
Primary practice location
4502 S Orange Blossom TRL
Orlando, FL 32839-1704
Mailing address
3543 Somerset Park Dr
Orlando, FL 32824-7346
Phone (813) 380-4306
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS52981 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1699387456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3543 SOMERSET PARK DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328247346",
"telephone_number": "813-380-4306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 S ORANGE BLOSSOM TRL",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328391704",
"telephone_number": "407-851-6040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADEYI",
"first_name": "SHANTANA",
"middle_name": "JANAE",
"name_prefix": "Dr.",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-21",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS52981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.