Individual provider Active NPI

Moyosore O Akinrimisi

  • Pharmacist
  • Lake Wylie, SC
National Provider Identifier
1720337090
Registry record updated Sep 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12520 Issued in SC
Practice address
158 Highway 274
Lake Wylie, SC 29710-6045
Phone
(803) 831-2605
Fax
(803) 831-9717
NPI assigned
Sep 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12520 SC Primary
Pharmacist 183500000X 18683 NC

Addresses

Primary practice location

158 Highway 274
Lake Wylie, SC 29710-6045

Mailing address

158 Highway 274
Lake Wylie, SC 29710-6045
Phone (803) 831-2605

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

LicenseStateTypeSpecialty
18683NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1346544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346544000000",
    "number": "1720337090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 HIGHWAY 274",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297106045",
            "telephone_number": "803-831-2605",
            "fax_number": "803-831-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 HIGHWAY 274",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297106045",
            "telephone_number": "803-831-2605",
            "fax_number": "803-831-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKINRIMISI",
        "first_name": "MOYOSORE",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-02",
        "last_updated": "2012-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "12520",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "18683",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wylie, SC

Sources for this page

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

Verify at the official NPI Registry.