Individual provider Active NPI

Lorena Moody, PHARM. D.

  • Pharmacist
  • Jackson, MS
National Provider Identifier
1265703334
Registry record updated Jan 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E8796 Issued in MS
Practice address
4607 Lindbergh Dr
Jackson, MS 39209-3855
Phone
(601) 353-6142
NPI assigned
Jan 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E8796 MS Primary

Addresses

Primary practice location

4607 Lindbergh Dr
Jackson, MS 39209-3855

Mailing address

343 Highleadon CT
Madison, MS 39110-7475

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

LicenseStateTypeSpecialty
E8796MSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1327190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327190400000",
    "number": "1265703334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 HIGHLEADON CT",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 LINDBERGH DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392093855",
            "telephone_number": "601-353-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "LORENA",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-22",
        "last_updated": "2012-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E8796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2012; 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.