Active NPI
Megan Moen
- Pharmacist
- Stillwater, MN
National Provider Identifier
1679828933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 120945
- Practice address
- 2021 Market Dr
T-0931
Stillwater, MN 55082-7546 - Phone
- (651) 439-0992
- Fax
- (651) 472-8062
- NPI assigned
- Jul 23, 2012
- Last updated
- Jul 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 120945 | MN | Primary |
Addresses
Primary practice location
2021 Market Dr
T-0931
Stillwater, MN 55082-7546
Mailing address
2021 Market Dr
Stillwater, MN 55082-7546
Phone (651) 439-0992
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 |
|---|---|---|---|
| 120945 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343001600000",
"number": "1679828933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2021 MARKET DR",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550827546",
"telephone_number": "651-439-0992",
"fax_number": "651-472-8062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 MARKET DR",
"address_2": "T-0931",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550827546",
"telephone_number": "651-439-0992",
"fax_number": "651-472-8062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOEN",
"first_name": "MEGAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-23",
"last_updated": "2012-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "120945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.