Active NPI
Shannon N Moore, PHARMD
- Pharmacist
- Indian Trail, NC
National Provider Identifier
1225333750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18317
- Practice address
- 4300 Old Monroe Rd
Indian Trail, NC 28079-5305 - Phone
- (704) 821-6551
- Fax
- (704) 821-6583
- NPI assigned
- Jan 13, 2011
- 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 | 18317 | NC | Primary |
Addresses
Primary practice location
4300 Old Monroe Rd
Indian Trail, NC 28079-5305
Mailing address
1028 Brook Valley Run
Monroe, NC 28110-6345
Phone (704) 989-3080
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 |
|---|---|---|---|
| 18317 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294876800000",
"number": "1225333750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1028 BROOK VALLEY RUN",
"city": "MONROE",
"state": "NC",
"postal_code": "281106345",
"telephone_number": "704-989-3080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 OLD MONROE RD",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280795305",
"telephone_number": "704-821-6551",
"fax_number": "704-821-6583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SHANNON",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-13",
"last_updated": "2011-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "18317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indian Trail, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.