Individual provider Active NPI

Brian D Moe, PHARMD

  • Pharmacist
  • Fargo, ND
National Provider Identifier
1609966035
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4750 Issued in ND
Practice address
3327 44TH Ave S
Fargo, ND 58104-6643
Phone
(701) 361-6237
NPI assigned
Oct 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4750 ND Primary

Addresses

Primary practice location

3327 44TH Ave S
Fargo, ND 58104-6643

Mailing address

3327 44TH Ave S
Fargo, ND 58104-6643
Phone (701) 361-6237

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

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609966035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 44TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046643",
            "telephone_number": "701-361-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 44TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046643",
            "telephone_number": "701-361-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "BRIAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "4750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.