Active NPI
Shane F Fagan
- Pharmacist
- Cambridge, OH
National Provider Identifier
1932743077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03439246
- Practice address
- 1045 Wheeling Ave
Cambridge, OH 43725-2441 - Phone
- (740) 432-9301
- NPI assigned
- Nov 1, 2019
- Last updated
- Nov 1, 2019
- 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 | 03439246 | OH | Primary |
Addresses
Primary practice location
1045 Wheeling Ave
Cambridge, OH 43725-2441
Mailing address
915 Taylor Ave
Cambridge, OH 43725-1530
Phone (724) 812-2457
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 |
|---|---|---|---|
| 03439246 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572566400000",
"number": "1932743077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 TAYLOR AVE",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437251530",
"telephone_number": "724-812-2457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 WHEELING AVE",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437252441",
"telephone_number": "740-432-9301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "SHANE",
"middle_name": "F",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-01",
"last_updated": "2019-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03439246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.