Individual provider Active NPI

Joe Moore

  • Pharmacist
  • Cleveland, TN
National Provider Identifier
1396105763
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0000005558 Issued in TN
Practice address
2401 N Ocoee St
Cleveland, TN 37311-3853
Phone
(423) 476-5548
Fax
(423) 476-2629
NPI assigned
Feb 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0000005558 TN Primary

Addresses

Primary practice location

2401 N Ocoee St
Cleveland, TN 37311-3853

Mailing address

PO Box 3240
Cleveland, TN 37320-3240
Phone (423) 476-5548

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
0000005558TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1396105763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3240",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373203240",
            "telephone_number": "423-476-5548",
            "fax_number": "423-476-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 N OCOEE ST",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113853",
            "telephone_number": "423-476-5548",
            "fax_number": "423-476-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0000005558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.