Individual provider Active NPI

Jason Albert Moreta

  • Pharmacy Technician
  • Mesa, AZ
National Provider Identifier
1205076635
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
T018526 Issued in AZ
Practice address
1322 S Country Club Dr
Mesa, AZ 85210-5130
Phone
(480) 831-6585
NPI assigned
Feb 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X T018526 AZ Primary

Addresses

Primary practice location

1322 S Country Club Dr
Mesa, AZ 85210-5130

Mailing address

6136 E McLellan Rd
Mesa, AZ 85205-3602
Phone (480) 218-1282

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

LicenseStateTypeSpecialty
T018526AZMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1205076635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 E MCLELLAN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852053602",
            "telephone_number": "480-218-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 S COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105130",
            "telephone_number": "480-831-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETA",
        "first_name": "JASON",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "AZ",
            "license": "T018526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.