Bryan Moore

Primary specialty

PharmacistTaxonomy code 183500000X

License

012715 Issued in KY

Practice address

101 W Showalter Dr
Georgetown, KY 40324-2081

Phone

(502) 868-6101

NPI assigned

Dec 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1659976058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CHEROKEE DR",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403919500",
            "telephone_number": "859-333-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W SHOWALTER DR",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403242081",
            "telephone_number": "502-868-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "012715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "012715",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Winchester",
            "affiliation": "N",
            "address_1": "159 Cherokee Dr",
            "city": "Winchester",
            "state": "KY",
            "country_code": "US",
            "postal_code": "403919500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Momentum Recovery Center, PLLC
• Monarq Transport
• Kylie Moneyhon
• Kristine Joy Galera Mongcopa
• Alyssa Brooke Moore, APRN
• Kallie Jo Moore
• Harry Morgan, CRNA
• Mary Kathryn Morgan, RD, LD
• Michelle Morgan, MA, CCC/SLP
• Ivan David Morrin, MD

• Pharmacist in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Pharmacist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.