Shannon Renee Moore

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH020367 Issued in GA

Practice address

13775 US 19 S
Thomasville, GA 31792-5398

Phone

(229) 228-6419

Fax

(229) 269-4422

NPI assigned

Jan 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Shannon Meemken Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Thomasville, GA
  • NPI 1285886895
  NPD (past)
• Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Valdosta, GA
  • NPI 1770822728
  NPD (past)
• Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Winter Haven, FL
  • NPI 1760356380
  NPD (past)

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1265779102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 INNER PERIMETER RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-671-9840",
            "fax_number": "229-269-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13775 US 19 S",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925398",
            "telephone_number": "229-228-6419",
            "fax_number": "229-269-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHANNON",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH020367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MEEMKEN",
            "prefix": "MRS.",
            "credential": "SHANNON KNIGHT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher J Mock, CRNA
• Dominic Anthony Monda, M.D.
• Shannon Elizabeth Moninger, NURSE PRACTITIONER
• Mark Moody, AA
• Kaitlynn Moore, NP
• Matthew Moree, DMD
• Mosaic Psychological Services, LLC
• Mosaic Therapy Services, LLC
• Shirley A Moye
• Mrs Homecare, Inc.

• Pharmacist in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.