Individual provider Active NPI

Tonya Shackelford, BS

  • Pharmacist
  • Memphis, TN
National Provider Identifier
1912275108
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11494 Issued in TN
Practice address
4300 New Getwell Rd
Memphis, TN 38118-6801
Phone
(901) 238-3784
Fax
(901) 284-0123
NPI assigned
Dec 2, 2011
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11494 TN Primary
Pharmacist 183500000X 11729 OK
Pharmacist 183500000X 2011 AR

Addresses

Primary practice location

4300 New Getwell Rd
Memphis, TN 38118-6801

Mailing address

4300 New Getwell Rd
Memphis, TN 38118-6801
Phone (901) 238-3784

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
11729OKMDMarriage & Family Therapist
2011ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1912275108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 NEW GETWELL RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381186801",
            "telephone_number": "901-238-3784",
            "fax_number": "901-284-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 NEW GETWELL RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381186801",
            "telephone_number": "901-238-3784",
            "fax_number": "901-284-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "TONYA",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "11494",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "11729",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "2011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.