Individual provider Active NPI

Shawn Powers

  • Pharmacist
  • Hamburg, NY
National Provider Identifier
1972105880
Registry record updated Nov 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
064973-1 Issued in NY
Practice address
4923 Lake Shore Rd
Hamburg, NY 14075-5662
Phone
(716) 627-3232
NPI assigned
Nov 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064973-1 NY Primary

Addresses

Primary practice location

4923 Lake Shore Rd
Hamburg, NY 14075-5662

Mailing address

58 Temple Dr
Cheektowaga, NY 14225-3615
Phone (716) 957-2783

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

LicenseStateTypeSpecialty
064973-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
J. Rutowski of Wanakah Inc. CurrentSince Sep 8, 2025 Accepting new patients

Locations

4923 Lake Shore Rd
Hamburg, NY 14075
Phone (716) 627-3232

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605398400000",
    "number": "1972105880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 TEMPLE DR",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142253615",
            "telephone_number": "716-957-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 LAKE SHORE RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755662",
            "telephone_number": "716-627-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-15",
        "last_updated": "2020-11-15",
        "certification_date": "2020-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064973-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2020; 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.