Active NPI
Trevor Ivan Shumaker
- Pharmacist
- Douglas, AZ
National Provider Identifier
1881118917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S021633
- Practice address
- 286 E 7TH St
Douglas, AZ 85607-2868 - Phone
- (520) 364-1358
- Fax
- (520) 364-6672
- NPI assigned
- Jul 31, 2017
- Last updated
- Jul 31, 2017
- Sex
- Male
- Sole proprietor
- No
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 | S021633 | AZ | Primary |
Addresses
Primary practice location
286 E 7TH St
Douglas, AZ 85607-2868
Mailing address
330 W Branding Iron Dr
Saint David, AZ 85630-6148
Phone (520) 240-1565
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
| License | State | Type | Specialty |
|---|---|---|---|
| S021633 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| German Dobson CVS LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501459200000",
"number": "1881118917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 W BRANDING IRON DR",
"city": "SAINT DAVID",
"state": "AZ",
"postal_code": "856306148",
"telephone_number": "520-240-1565",
"fax_number": "520-364-6672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "286 E 7TH ST",
"city": "DOUGLAS",
"state": "AZ",
"postal_code": "856072868",
"telephone_number": "520-364-1358",
"fax_number": "520-364-6672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUMAKER",
"first_name": "TREVOR",
"middle_name": "IVAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-31",
"last_updated": "2017-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S021633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglas, AZ
- Safeway Inc (Safeway Pharmacy #1139)
- Sarah Ann Samuel, PHARMD
- Harley G Schalesky, MD
- Cheryl E Schmitt, O.D.
- Mechelle Lynette Shea
- Julie Ann Siddens, SLP
- South Eastern Arizona Behavioral Health Services, Inc. (Douglas Integrated Counseling Clinic)
- Southeastern Arizona Behavioral Health Service, Inc
- Southeastern Arizona Behavioral Health Services, Inc.
- Betty Lynn Spering, LISAC, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.