Active NPI
Moses Nimo, PHARMACIST
- Pharmacist
- Tulsa, OK
National Provider Identifier
1225707276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19381
- Practice address
- 5046 S Sheridan Rd
Tulsa, OK 74145-5714 - Phone
- (918) 627-6464
- NPI assigned
- Sep 12, 2021
- Sex
- Male
- Sole proprietor
- No
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 | 19381 | OK | Primary |
Addresses
Primary practice location
5046 S Sheridan Rd
Tulsa, OK 74145-5714
Mailing address
4414 W Madison PL
Broken Arrow, OK 74012-8542
Phone (918) 406-0826
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 |
|---|---|---|---|
| 19381 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631404800000",
"number": "1225707276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4414 W MADISON PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740128542",
"telephone_number": "918-406-0826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5046 S SHERIDAN RD",
"city": "TULSA",
"state": "OK",
"postal_code": "741455714",
"telephone_number": "918-627-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIMO",
"first_name": "MOSES",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-12",
"last_updated": "2021-09-12",
"certification_date": "2021-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "19381",
"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 Sep 12, 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.