Individual provider Active NPI

Tiffany Ann Moore, PHARM.D.

  • Pharmacist
  • Lakewood, CO
National Provider Identifier
1518099076
Registry record updated Apr 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17643 Issued in CO
Practice address
13111 W Alameda Pkwy
Lakewood, CO 80228-3108
Phone
(303) 980-0283
Fax
(303) 980-0923
NPI assigned
Mar 11, 2007
Last updated
Apr 25, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00065407 WA
Pharmacist 183500000X 17643 CO Primary
Pharmacist 183500000X 3149 WY

Addresses

Primary practice location

13111 W Alameda Pkwy
Lakewood, CO 80228-3108

Mailing address

6339 W Roxbury PL
Littleton, CO 80128-4675
Phone (303) 954-8932

Other identifiers 3

IdentifierTypeStateIssuer
3149OtherWYPHARMACIST
PH00065407OtherWAPHARMACIST
17643OtherCOPHARMACIST

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
17643COMDPharmacist
PH00065407WAMDPharmacist
3149WYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272153600000",
    "number": "1518099076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6339 W ROXBURY PL",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801284675",
            "telephone_number": "303-954-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 W ALAMEDA PKWY",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802283108",
            "telephone_number": "303-980-0283",
            "fax_number": "303-980-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-11",
        "last_updated": "2010-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00065407",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "17643",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "3149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "3149",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "PH00065407",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "17643",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2010; 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.