Active NPI
Joseph Crockett Shaffer II
- Pharmacist
- Wilmington, NC
National Provider Identifier
1891927166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9504
- Practice address
- 3501 Oleander Dr
Wilmington, NC 28403 - Phone
- (910) 762-6300
- Fax
- (910) 762-1535
- NPI assigned
- Aug 19, 2009
- 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 | 9504 | NC | Primary |
Addresses
Primary practice location
3501 Oleander Dr
Wilmington, NC 28403
Mailing address
3501 Oleander Dr
Wilmington, NC 28403
Phone (910) 762-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0655969 | Medicaid | NC |
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 |
|---|---|---|---|
| 9504 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1891927166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 OLEANDER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "28403",
"telephone_number": "910-762-6300",
"fax_number": "910-762-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 OLEANDER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "28403",
"telephone_number": "910-762-6300",
"fax_number": "910-762-1535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "JOSEPH",
"middle_name": "CROCKETT",
"name_prefix": "Mr.",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-19",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "9504",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0655969",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.