Brett Michael Moore, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

26030571A Issued in IN

Practice address

4120 N Clinton St
Fort Wayne, IN 46805-1230

Phone

(260) 484-7021

NPI assigned

Apr 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1528810686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 CANTERBURY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353202",
            "telephone_number": "740-649-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051230",
            "telephone_number": "260-484-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRETT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "03443939",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26030571A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven J. Mooibroek, M.D.
• Raymond Gerard Moon-Gabet, LSW
• Moonstone Midwifery & Family Health
• Aaron Moore, RBT
• Ann Margaret Moore, D.O.
• Christine Moore, RD
• Christopher W Moore, PA
• Cynthia Moore
• Daniel Thomas Moore, M.D.
• Diana Moore, LMFT, LMHC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.