Laura A Shull

Primary specialty

PharmacistTaxonomy code 183500000X

License

26016090A Issued in IN

Practice address

218 E Pettit Ave
Fort Wayne, IN 46806-3038

Phone

(260) 456-4736

Fax

(260) 744-5053

NPI assigned

Nov 22, 2019

Last updated

Nov 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kroger Limited Partnership I

  dba Kroger Pharmacy

  • Community/Retail Pharmacy
  • Fort Wayne, IN
  • NPI 1679646293
  NPD (past)
• Kroger Limited Partnership I

  dba Kroger Pharmacy #473

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1891331013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E PETTIT AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468063038",
            "telephone_number": "260-456-4736",
            "fax_number": "260-744-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E PETTIT AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468063038",
            "telephone_number": "260-456-4736",
            "fax_number": "260-744-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "LAURA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26016090A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert McDowell Shugart II
• Ellen Shuherk
• Abhijit Shukla, M.D.
• Allison Lucy Shuler, MOTR/L
• Katie Ann Shull, LCMHA
• Pamela Shull
• Clifford James Shultz, MD
• Elizabeth Jo Shultz, PHARMD
• Zachary Shultz
• Jack Kevin Shumaker, OT

• Pharmacist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.