Individual provider Active NPI

Jeannie Shum, PHARMD

  • Pharmacist
  • Parkville, MD
National Provider Identifier
1992052302
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20788 Issued in MD
Practice address
8858 Waltham Woods Rd
Parkville, MD 21234-2402
Phone
(410) 882-8825
Fax
(410) 882-8841
NPI assigned
Aug 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20788 MD Primary

Addresses

Primary practice location

8858 Waltham Woods Rd
Parkville, MD 21234-2402

Mailing address

8858 Waltham Woods Rd
Parkville, MD 21234-2402
Phone (410) 882-8825

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20788MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1992052302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8858 WALTHAM WOODS RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212342402",
            "telephone_number": "410-882-8825",
            "fax_number": "410-882-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8858 WALTHAM WOODS RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212342402",
            "telephone_number": "410-882-8825",
            "fax_number": "410-882-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUM",
        "first_name": "JEANNIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "20788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.