Individual provider Active NPI

Kiara Moad

  • Pharmacist
  • Boulder City, NV
National Provider Identifier
1306661673
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24383 Issued in NV
Practice address
1017 Nevada Way
Boulder City, NV 89005-1801
Phone
(702) 293-6705
NPI assigned
Nov 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S027327 AZ
Pharmacist 183500000X 24383 NV Primary

Addresses

Primary practice location

1017 Nevada Way
Boulder City, NV 89005-1801

Mailing address

1264 Arcadia Rim PL
Henderson, NV 89002-3456

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

LicenseStateTypeSpecialty
S027327AZMDPharmacist
24383NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada CVS Pharmacy LLC CurrentSince Nov 24, 2024 Accepting new patients
Nevada CVS Pharmacy LLC PastSince Nov 24, 2024 Accepting new patients

Locations

1017 Nevada Way
Boulder City, NV 89005
Phone (702) 293-6705

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1306661673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 ARCADIA RIM PL",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890023456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 NEVADA WAY",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051801",
            "telephone_number": "702-293-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAD",
        "first_name": "KIARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S027327",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "24383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.