Active NPI
Marvin Robert Moore, PHARM.D.
- Pharmacist
- Two Rivers, WI
National Provider Identifier
1023008166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13645
- Practice address
- 1500 Washington St
Two Rivers, WI 54241-3045 - Phone
- (920) 794-1225
- NPI assigned
- Oct 27, 2005
- 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 | 13645 | WI | Primary |
Addresses
Primary practice location
1500 Washington St
Two Rivers, WI 54241-3045
Mailing address
1500 Washington St
Two Rivers, WI 54241-3045
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13645 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023008166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 WASHINGTON ST",
"city": "TWO RIVERS",
"state": "WI",
"postal_code": "542413045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WASHINGTON ST",
"city": "TWO RIVERS",
"state": "WI",
"postal_code": "542413045",
"telephone_number": "920-794-1225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MARVIN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Two Rivers, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.