Active NPI
Shauna Renee Peterson, D.PH.
- Pharmacist
- Lexington, SC
National Provider Identifier
1740565233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11723
- Practice address
- 105 Everleigh CT
Lexington, SC 29072-7114 - Phone
- (803) 520-8463
- NPI assigned
- Oct 15, 2011
- 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 | 11723 | OK | Primary |
Addresses
Primary practice location
105 Everleigh CT
Lexington, SC 29072-7114
Mailing address
105 Everleigh CT
Lexington, SC 29072-7114
Phone (803) 520-8463
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 |
|---|---|---|---|
| 11723 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318636800000",
"number": "1740565233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 EVERLEIGH CT",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290727114",
"telephone_number": "803-520-8463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 EVERLEIGH CT",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290727114",
"telephone_number": "803-520-8463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "SHAUNA",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "D.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-15",
"last_updated": "2011-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "11723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.