Individual provider Active NPI

Shawna Ray Wilson, CPHT

  • Pharmacy Technician
  • Allegan, MI
National Provider Identifier
1801300587
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
30020979 Issued in MI
Practice address
115 Locust St
Allegan, MI 49010-1301
Phone
(269) 673-4188
NPI assigned
Nov 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 30020979 MI Primary

Addresses

Primary practice location

115 Locust St
Allegan, MI 49010-1301

Mailing address

115 Locust St
Allegan, MI 49010-1301

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
30020979MIMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1801300587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LOCUST ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LOCUST ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101301",
            "telephone_number": "269-673-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHAWNA",
        "middle_name": "RAY",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MI",
            "license": "30020979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.