MR. SHAWN M FREESE (NPI# 1063530244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063530244 |
| Entity Type | Individual |
| Full Name | MR. SHAWN M FREESE |
| Credential | RPH. |
| Practice Address |
1100 W Argyle St Jackson MI 49202-2059 |
| Mailing Address |
3836 Deerfield Dr Jackson MI 49203-1107 |
| Practice Telephone | 5177885476 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-12-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302028811 | MI | Pharmacy Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
5302028811 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 5302028811 | PHARMACY LICENSE | 01 |
| Street Address |
1100 W ARGYLE ST |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-2059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386678142 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 1100 W Argyle St, Jackson, MI 49202-2059 | 2006-07-10 |
| 1376180190 | Matthew Gregory Benz | Pharmacist | 1100 W Argyle St, Jackson, MI 49202-2059 | 2019-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890662 | Angela Shawn Bradley | Pharmacist | 1589 Ky Hwy 15 South, Jackson, KY 41339 | 2020-10-30 |
| 1871191734 | Ranita Greer | Pharmacist | 59 Ky-15 N, Jackson, KY 41339 | 2020-10-13 |
| 1790398287 | Haleema Saadia | Pharmacist | 3144 North Avenue, Jackson, TN 38305-0100 | 2020-08-25 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1124645965 | Archis B Patel | Pharmacist | 6 Moet Ct, Jackson, NJ 08527-3090 | 2020-06-27 |
| 1417579798 | Alvin Ray Stewart Sr. | Pharmacist | 696 Cedar Springs Dr, Jackson, MS 39212-5710 | 2020-05-10 |
| 1033731492 | Jamie Hines Mckinley | Pharmacist | 1500 E Woodrow Wilson Ave Dept 119-a, Jackson, MS 39216-5116 | 2020-05-08 |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1770130650 | Elizabeth Hearn | Pharmacist | 1345 Simwood Pl, Jackson, MS 39211-6352 | 2019-08-24 |
| 1306493929 | Stephen Benjamin Porter | Pharmacist | 350 W Woodrow Wilson Ave Rm Me101-42, Jackson, MS 39213-7681 | 2019-08-19 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.