Active NPI
Shannon Marie Kennedy, RPH
- Pharmacist
- Saint Albans, WV
National Provider Identifier
1902159486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0005776
- Practice address
- 1477 Maccorkle Ave
Saint Albans, WV 25177-1826 - Phone
- (304) 722-4246
- NPI assigned
- Oct 20, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0005776 | WV | Primary |
Addresses
Primary practice location
1477 Maccorkle Ave
Saint Albans, WV 25177-1826
Mailing address
1477 Maccorkle Ave
Saint Albans, WV 25177-1826
Phone (304) 722-4246
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP0005776 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350691200000",
"number": "1902159486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1477 MACCORKLE AVE",
"city": "SAINT ALBANS",
"state": "WV",
"postal_code": "251771826",
"telephone_number": "304-722-4246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1477 MACCORKLE AVE",
"city": "SAINT ALBANS",
"state": "WV",
"postal_code": "251771826",
"telephone_number": "304-722-4246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "SHANNON",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-20",
"last_updated": "2012-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0005776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Albans, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.