Active NPI
Terrell Dea Moorhead
- Pharmacist
- Tulsa, OK
National Provider Identifier
1154926319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8615
- Practice address
- 9211 S Yale Ave
Tulsa, OK 74137 - Phone
- (918) 494-5647
- NPI assigned
- Dec 3, 2020
- Last updated
- Dec 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 8615 | OK | Primary |
Addresses
Primary practice location
9211 S Yale Ave
Tulsa, OK 74137
Mailing address
9122 S Yale Ave
Tulsa, OK 74137-4039
Phone (918) 494-5647
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8615 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oklahoma CVS Pharmacy LLC | Past | Accepting new patients | |
| Oklahoma CVS Pharmacy LLC | Past | Accepting new patients |
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, 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": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1154926319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9122 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741374039",
"telephone_number": "918-494-5647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9211 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "74137",
"telephone_number": "918-494-5647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORHEAD",
"first_name": "TERRELL",
"middle_name": "DEA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "8615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.