Dominique Shaw, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH028142 Issued in GA

Practice address

450 Northside Cherokee Blvd
Canton, GA 30115-8015

Phone

(770) 224-1200

NPI assigned

Apr 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651276800000",
    "number": "1720723174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 CHADWICK DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300288118",
            "telephone_number": "678-776-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NORTHSIDE CHEROKEE BLVD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158015",
            "telephone_number": "770-224-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "DOMINIQUE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-30",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH028142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cerner",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "450 Northside Cherokee Blvd",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301158015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Prapti Shah
• Synquisite Tiere Shamlee, CSA
• Gayatri Shangari, M.D.
• Gary A Shankman, PTA
• Megha Lalit Sharma, MD
• Stephen Shearer, RPH, MS
• Kelly Sheats
• Kathy Blakley Sheffey, RPH
• Yelena Shell
• Adam Shelp

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.