Individual provider Active NPI

Gerri Moore Mosholder, RPH

  • Pharmacist
  • Suwanee, GA
National Provider Identifier
1629315494
Registry record updated Jan 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
017829 Issued in GA
Practice address
1000 Peachtree Industrial Blvd
Suwanee, GA 30024-6737
Phone
(770) 932-4306
NPI assigned
Jan 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 017829 GA Primary
Pharmacist 183500000X 09422 NC

Addresses

Primary practice location

1000 Peachtree Industrial Blvd
Suwanee, GA 30024-6737

Mailing address

6625 Callanwalde CT
Suwanee, GA 30024-4277
Phone (678) 642-9700

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
017829GAMDPharmacist
09422NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1358035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358035200000",
    "number": "1629315494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 CALLANWALDE CT",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244277",
            "telephone_number": "678-642-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PEACHTREE INDUSTRIAL BLVD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246737",
            "telephone_number": "770-932-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHOLDER",
        "first_name": "GERRI",
        "middle_name": "MOORE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-13",
        "last_updated": "2013-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "017829",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "09422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2013; 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.