Active NPI
Alyssa M Moon, PHARM.D.
- Pharmacist
- Fort Washington, MD
National Provider Identifier
1215337498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22560
- Practice address
- 11906 Livingston Rd
Fort Washington, MD 20744-4286 - Phone
- (724) 554-9691
- NPI assigned
- Aug 25, 2014
- Last updated
- Aug 25, 2014
- Sex
- Female
- 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 | 22560 | MD | Primary |
Addresses
Primary practice location
11906 Livingston Rd
Fort Washington, MD 20744-4286
Mailing address
3485 Promenade PL Apt 203
Waldorf, MD 20603-7282
Phone (724) 554-9691
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22560 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408924800000",
"number": "1215337498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3485 PROMENADE PL APT 203",
"city": "WALDORF",
"state": "MD",
"postal_code": "206037282",
"telephone_number": "724-554-9691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11906 LIVINGSTON RD",
"city": "FORT WASHINGTON",
"state": "MD",
"postal_code": "207444286",
"telephone_number": "724-554-9691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "ALYSSA",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-25",
"last_updated": "2014-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "22560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Washington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.