PETER SHIM (NPI# 1710510300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710510300 |
| Entity Type | Individual |
| Full Name | PETER SHIM |
| Practice Address |
5005 Douglas Ave Racine WI 53402-2027 |
| Practice Telephone | 2626399241 |
| Mailing Telephone | 2626399241 |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 19255-40 | WI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669854212 | Peter Shim | Dentist | 6900 Forest Ave Ste 110, Richmond, VA 23230-1730 | 2015-06-19 |
| Street Address |
5005 DOUGLAS AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53402-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598770646 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5005 Douglas Ave, Racine, WI 53402-2027 | 2006-07-29 |
| 1831723469 | Eric Christian Koski Sr. | Pharmacist | 5005 Douglas Ave, Racine, WI 53402-2027 | 2020-02-21 |
| 1740557818 | Odunola George | Pharmacist | 5005 Douglas Ave, Racine, WI 53402-2027 | 2011-11-17 |
| 1275800443 | James W Rieser II | Pharmacist | 5005 Douglas Ave, Racine, WI 53402-2027 | 2011-11-16 |
| 1306122403 | Thomas Robert Hart | Pharmacist | 5005 Douglas Ave, Racine, WI 53402-2027 | 2011-11-02 |
| 1831475813 | Joel E Johnson | Pharmacist | 5005 Douglas Ave, Racine, WI 53402-2027 | 2011-10-23 |
| 1467736991 | Ticy Varughese | Pharmacist | 5005 Douglas Ave, Racine, WI 53402-2027 | 2011-10-03 |
| 1942582754 | Terry Donald Hess | Pharmacist | 5005 Douglas Ave, Racine, WI 53402-2027 | 2011-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215586847 | Jennifer Ann Wagener | Technician | 1513 Melvin Ave, Racine, WI 53402 | 2019-09-06 |
| 1023530490 | Tahir Vora | Pharmacist | 6840 Middle Rd Apt 8, Racine, WI 53402 | 2017-07-07 |
| 1154852069 | Golden Path Services | Home Health | 1700 North Main Street, Upper, Racine, WI 53402 | 2017-03-22 |
| 1376842690 | Vashir Jim Xiong | Acupuncturist | 3726 Ruby Ave, Racine, WI 53402 | 2011-03-25 |
| 1215248927 | Andrew M Asbury | Family Medicine | 2408 Four Mile Rd, Racine, WI 53402 | 2010-06-28 |
| 1215058532 | Lakeshore Family Dental Care Sc | Dentist | 3903 Douglas Ave, Racine, WI 53402 | 2007-04-03 |
| 1679626915 | David Ramon Reesman | Dentist | 3900 North Bay Dr, Racine, WI 53402 | 2007-01-19 |
| 1639286958 | Mary E Pagano | Internal Medicine | 5333 Douglas Ave, Racine, WI 53402 | 2006-08-23 |
| 1881605111 | Caledonia Chiropractic Clinic, Sc | Chiropractor | 5401 Douglas Ave, Suite A, Racine, WI 53402 | 2006-08-11 |
| 1003923996 | David C Zablotney | Family Medicine | 5333 Douglas Ave, Racine, WI 53402 | 2006-08-24 |
| Find all providers in zip 53402 | ||||
| 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 |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1174930358 | Craig John Borgardt | Pharmacist | 6520 Hidden Creek Rd, Racine, WI 53402-9403 | 2014-07-19 |
| 1184038655 | Sunday Muniz | Pharmacist | 5220 Washington Ave, Ste 101, Racine, WI 53406-4228 | 2014-06-12 |
| 1033486592 | Paul Byron Anthony | Pharmacist | 5104 Cortland Ave, Racine, WI 53406 | 2011-11-28 |
| 1407132194 | John Thomas Keil | Pharmacist | 116 Northwood Dr, Racine, WI 53402-1938 | 2011-10-26 |
| 1982926507 | Mark Edward Buhler | Pharmacist | 2211 S Green Bay Rd, Racine, WI 53406-4919 | 2010-02-23 |
| 1033115787 | Mark A. Pelton | Pharmacist | 3801 Spring St, Racine, WI 53405-1667 | 2005-06-27 |
| 1144855008 | Jason Slaasted | Pharmacist | 4810 Washington Ave, Racine, WI 53406-4220 | 2020-03-11 |
| 1780218941 | Nicholas Kuroski | Pharmacist | 4810 Washington Ave, Racine, WI 53406-4220 | 2020-02-26 |
| 1871127407 | Ngan T Le | Pharmacist | 1920 Douglas Ave, Racine, WI 53402-4614 | 2020-02-22 |
| Find all providers in RACINE | ||||
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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.