Individual provider Active NPI

Anna Nguyen Moyer, PHARM.D.

  • Geriatric Pharmacist
  • Ponte Vedra, FL
National Provider Identifier
1083936462
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric PharmacistTaxonomy code 1835G0303X
License
PU7240 Issued in FL
Practice address
145 Hilden Rd Ste 102
Ponte Vedra, FL 32081-8401
Phone
(904) 600-4099
NPI assigned
Feb 25, 2010
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS49455 FL
Pharmacist 183500000X 16513 NC
Geriatric Pharmacist 1835G0303X PU7240 FL Primary

Addresses

Primary practice location

145 Hilden Rd Ste 102
Ponte Vedra, FL 32081-8401

Mailing address

145 Hilden Rd Ste 102
Ponte Vedra, FL 32081-8401
Phone (904) 600-4099

Other practice location 1

1220 Matthews Township Pkwy
Matthews, NC 28105-0218
Phone (704) 814-9487

Other practice location 2

1220 Matthews Township Pkwy
Matthews, NC 28105-0218
Phone (704) 814-9487

Other identifiers 1

IdentifierTypeStateIssuer
0601016MedicaidNC

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
PS49455FLMDPharmacist
PU7240FLMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1083936462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HILDEN RD STE 102",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320818401",
            "telephone_number": "904-600-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HILDEN RD STE 102",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320818401",
            "telephone_number": "904-600-4099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Matthews Township Pkwy",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281050218",
            "country_code": "US",
            "telephone_number": "704-814-9487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 Matthews Township Pkwy",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281050218",
            "country_code": "US",
            "telephone_number": "704-814-9487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN MOYER",
        "first_name": "ANNA",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS49455",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "16513",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "FL",
            "license": "PU7240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0601016",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.