Devera Moeller, PHARMD

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

PHH004103 Issued in GA

Practice address

201 Hospital Rd
Canton, GA 30114-2408

Phone

(770) 721-4190

Fax

(770) 720-5455

NPI assigned

Sep 19, 2016

Last updated

Sep 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1023566163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 BEAUMONT CT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148186",
            "telephone_number": "770-721-4190",
            "fax_number": "770-720-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HOSPITAL RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142408",
            "telephone_number": "770-721-4190",
            "fax_number": "770-720-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "DEVERA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "PHH004103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Mitchell
• Tia Marie Mitcheltree
• Crystal Mizell
• Khushbu Modi
• Mackenzie Rylee Modica
• Poya Moghadam, DMD
• Monac Mobility LLC
• Grant Herron Moody, MD
• Michaela Moody
• Matthew Eugene Moon, FNP

• General Acute Care Hospital in Canton, GA
• Providers in Canton, GA by specialty
• General Acute Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.