Active NPI
James Lee Moore, RPH
- Pharmacist
- Onalaska, WI
National Provider Identifier
1306185392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12416
- Practice address
- 111 Sand Lake Rd
Onalaska, WI 54650-2760 - Phone
- (608) 775-8563
- NPI assigned
- Feb 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12416 | WI | Primary |
| Pharmacist | 183500000X | 13944 | GA |
Addresses
Primary practice location
111 Sand Lake Rd
Onalaska, WI 54650-2760
Mailing address
111 Sand Lake Rd
Onalaska, WI 54650-2760
Phone (608) 775-8563
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12416 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360540800000",
"number": "1306185392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 SAND LAKE RD",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546502760",
"telephone_number": "608-775-8563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SAND LAKE RD",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546502760",
"telephone_number": "608-775-8563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JAMES",
"middle_name": "LEE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-11",
"last_updated": "2013-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "12416",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "13944",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Onalaska, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.