Individual provider Active NPI

James Joseph Moore II, RPH

  • Pharmacist
  • Canton, CT
National Provider Identifier
1659637775
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0012532 Issued in CT
Practice address
111 Albany Tpke
Canton, CT 06019-2507
Phone
(860) 693-8077
Fax
(860) 693-6922
NPI assigned
Apr 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0012532 CT Primary

Addresses

Primary practice location

111 Albany Tpke
Canton, CT 06019-2507

Mailing address

111 Albany Tpke
Canton, CT 06019-2507
Phone (860) 693-8077

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
PCT.0012532CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC Past Accepting new patients
CVS Albany LLC Past Accepting new patients
Connecticut CVS Pharmacy LLC PastSince Nov 22, 2020 Accepting new patients
Connecticut CVS Pharmacy LLC PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1659637775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ALBANY TPKE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192507",
            "telephone_number": "860-693-8077",
            "fax_number": "860-693-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ALBANY TPKE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192507",
            "telephone_number": "860-693-8077",
            "fax_number": "860-693-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JAMES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0012532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.