Individual provider Active NPI

Deborah Moos, BS, RPH, MBA

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Midwest City, OK
National Provider Identifier
1073848693
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
114197 Issued in MN
Practice address
1390 S Douglas Blvd
Ste 102
Midwest City, OK 73130-5270
Phone
(405) 455-5312
Fax
(405) 455-5279
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 114197 MN Primary
Rehabilitation Counselor 225C00000X

Addresses

Primary practice location

1390 S Douglas Blvd
Ste 102
Midwest City, OK 73130-5270

Mailing address

8301 N Council Rd Apt 1103
Oklahoma City, OK 73132-4186
Phone (405) 728-1138

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
Bachelor of Science, Master of Business Administration, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
114197MNMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Above All Behavioral Health Services, LLC Past Accepting new patients

Organizations & group practices 1

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1073848693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 N COUNCIL RD APT 1103",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731324186",
            "telephone_number": "405-728-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 S DOUGLAS BLVD",
            "address_2": "STE 102",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731305270",
            "telephone_number": "405-455-5312",
            "fax_number": "405-455-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOS",
        "first_name": "DEBORAH",
        "credential": "BS, RPH, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "114197",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.