Active NPI
Tracie L. Sanjume, PHARMD, BCPS, CDCES
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Jbphh, HI
National Provider Identifier
1861481046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 2349
- Practice address
- 480 Central Ave
Jbphh, HI 96860-4908 - Phone
- (808) 473-1880
- Fax
- (808) 473-4449
- NPI assigned
- Oct 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 2349 | HI | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 2349 | HI | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 53772 | CA | |
| Pharmacotherapy Pharmacist | 1835P1200X | 53772 | CA |
Addresses
Primary practice location
480 Central Ave
Jbphh, HI 96860-4908
Mailing address
Naval Health Clinic Hawaii
480 Central Avenue
Pearl Harbor, HI 96860-4908
Phone (808) 473-1880
Other names 1
- Tracie L. Shimizu
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 |
|---|---|---|---|
| 2349 | HI | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1861481046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL HEALTH CLINIC HAWAII",
"address_2": "480 CENTRAL AVENUE",
"city": "PEARL HARBOR",
"state": "HI",
"postal_code": "968604908",
"telephone_number": "808-473-1880",
"fax_number": "808-473-4449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 CENTRAL AVE",
"city": "JBPHH",
"state": "HI",
"postal_code": "968604908",
"telephone_number": "808-473-1880",
"fax_number": "808-473-4449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANJUME",
"first_name": "TRACIE",
"middle_name": "L.",
"credential": "PHARMD, BCPS, CDCES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-19",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "HI",
"license": "2349",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "HI",
"license": "2349",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "53772",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "CA",
"license": "53772",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TRACIE",
"last_name": "SHIMIZU",
"middle_name": "L.",
"credential": "PHARMD, BCPS, CDCES",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Jbphh, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.