Individual provider Active NPI

Shaun C Shah

  • Pharmacist
  • Canton, MA
National Provider Identifier
1780967604
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH26567 Issued in MA
Practice address
595 Washington St
Canton, MA 02021-3007
Phone
(781) 828-2375
Fax
(781) 575-1583
NPI assigned
Sep 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH26567 MA Primary

Addresses

Primary practice location

595 Washington St
Canton, MA 02021-3007

Mailing address

95 Dix St Apt 2
Dorchester, MA 02122-1272

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
PH26567MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Eastern Co Inc Past Accepting new patients
Walgreen Eastern Co Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1780967604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 DIX ST APT 2",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021221272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 WASHINGTON ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020213007",
            "telephone_number": "781-828-2375",
            "fax_number": "781-575-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHAUN",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH26567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

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

Verify at the official NPI Registry.