Active NPI
Michael Evan Shore, PHARMD
- Pharmacist
- Longmont, CO
National Provider Identifier
1790037695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17383
- Practice address
- 551 S Hover St
Longmont, CO 80501-7920 - Phone
- (720) 864-4394
- NPI assigned
- Oct 3, 2012
- Last updated
- Oct 3, 2012
- Sex
- Male
- 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 | 17383 | CO | Primary |
Addresses
Primary practice location
551 S Hover St
Longmont, CO 80501-7920
Mailing address
400 Cheyenne Dr
Lafayette, CO 80026-9229
Phone (720) 280-2701
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17383 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1790037695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 CHEYENNE DR",
"city": "LAFAYETTE",
"state": "CO",
"postal_code": "800269229",
"telephone_number": "720-280-2701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "551 S HOVER ST",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805017920",
"telephone_number": "720-864-4394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORE",
"first_name": "MICHAEL",
"middle_name": "EVAN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-03",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "17383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.