Active NPI
Clover Moten
- Pharmacist
- Kerrville, TX
National Provider Identifier
1669219010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 74247
- Practice address
- 112 Main St
Kerrville, TX 78028-5204 - Phone
- (830) 895-3311
- NPI assigned
- Jul 12, 2024
- Last updated
- Jul 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 74247 | TX | Primary |
Addresses
Primary practice location
112 Main St
Kerrville, TX 78028-5204
Mailing address
1435 W Lynwood Ave
San Antonio, TX 78201-4551
Phone (210) 296-5954
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74247 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1669219010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1435 W LYNWOOD AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782014551",
"telephone_number": "210-296-5954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 MAIN ST",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780285204",
"telephone_number": "830-895-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTEN",
"first_name": "CLOVER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-12",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "74247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kerrville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.