Individual provider Active NPI

Shawn Yaldo

  • Pharmacist
  • West Bloomfield, MI
National Provider Identifier
1740657519
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302040914 Issued in MI
Practice address
6427 Orchard Lake Rd
West Bloomfield, MI 48322-2333
Phone
(248) 626-3400
Fax
(248) 865-7784
NPI assigned
Aug 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302040914 MI Primary

Addresses

Primary practice location

6427 Orchard Lake Rd
West Bloomfield, MI 48322-2333

Mailing address

4132 Crooks St
West Bloomfield, MI 48323-1225
Phone (248) 935-1772

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

LicenseStateTypeSpecialty
5302040914MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1740657519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 CROOKS ST",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231225",
            "telephone_number": "248-935-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6427 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222333",
            "telephone_number": "248-626-3400",
            "fax_number": "248-865-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YALDO",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302040914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.