Individual provider Active NPI

Kimberly Holden Shakur, PHARMD

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1710432174
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
62797 Issued in CA
Practice address
757 Westwood PLZ
B504A
Los Angeles, CA 90095-8358
Phone
(310) 267-7721
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 62797 CA Primary
Pharmacist 183500000X PS40114 FL
Pharmacist 183500000X 26380 MA
Pharmacist 183500000X PH3725 HI

Addresses

Primary practice location

757 Westwood PLZ
B504A
Los Angeles, CA 90095-8358

Mailing address

6320 Green Valley Cir
Apt 200
Culver City, CA 90230-7078
Phone (352) 514-5582

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
62797CAMDPharmacist
PS40114FLMDPharmacist
PH3725HIMDPharmacist
26380MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1710432174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 GREEN VALLEY CIR",
            "address_2": "APT 200",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307078",
            "telephone_number": "352-514-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "address_2": "B504A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-267-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKUR",
        "first_name": "KIMBERLY",
        "middle_name": "HOLDEN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "62797",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40114",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "26380",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH3725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.