Kelly Moore, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

24381 Issued in MD

Practice address

28 Magothy Beach Rd
Pasadena, MD 21122-4428

Phone

(410) 437-6450

NPI assigned

Aug 17, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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.

• Maryland CVS Pharmacy, L.L.C.

  • Pharmacy
  • Gaithersburg, MD
  • NPI 1669100285
  NPD (past)

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1285189597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MAGOTHY BEACH RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224428",
            "telephone_number": "410-437-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MAGOTHY BEACH RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224428",
            "telephone_number": "410-437-6450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2509-2523 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21217",
            "country_code": "US",
            "telephone_number": "240-604-5581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2022-01-08",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "24381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Miller
• Susan Christine Miller, C.R.N.P
• Krystina M Mints, CRNP
• Minuteclinic LLC
• Modern Dentistry 1 LLC
• Marquita Moore, MSOT, OTR/L
• Rigel Alinda Moore
• Shane Matthew Morales
• Desiree Brooke Morsberger, CRNP
• Kathy Virginia Mouncey, R.N.

• Pharmacist in Pasadena, MD
• Providers in Pasadena, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; 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.