Individual provider Active NPI

Joseph S Moose, PHARM.D.

  • Pharmacist
  • Concord, NC
National Provider Identifier
1043354327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11002 Issued in NC
Practice address
270 Copperfield Blvd NE
Suite 101
Concord, NC 28025-2441
Phone
(704) 784-9613
Fax
(704) 789-9366
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11002 NC Primary

Addresses

Primary practice location

270 Copperfield Blvd NE
Suite 101
Concord, NC 28025-2441

Mailing address

PO Box 1366
1215 N Main St
Mt Pleasant, NC 28124-1366
Phone (704) 783-5483

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
11002NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Moose Pharmacy of Monroe LLC Current Accepting new patients
Moose Pharmacy of Monroe Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joseph.moose@direct.moosepharmacy.nchie.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043354327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1366",
            "address_2": "1215 N MAIN ST",
            "city": "MT PLEASANT",
            "state": "NC",
            "postal_code": "281241366",
            "telephone_number": "704-783-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE",
            "address_2": "SUITE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-784-9613",
            "fax_number": "704-789-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSE",
        "first_name": "JOSEPH",
        "middle_name": "S",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "11002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.