Active NPI
Jennnifer Renee Moulton, RPH
- Pharmacist
- Des Moines, IA
National Provider Identifier
1780803213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18248
- Practice address
- 8515 Douglas Ave
Suite 16
Des Moines, IA 50322-2924 - Phone
- (515) 270-0713
- Fax
- (515) 270-2979
- NPI assigned
- Apr 24, 2007
- 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 | 18248 | IA | Primary |
Addresses
Primary practice location
8515 Douglas Ave
Suite 16
Des Moines, IA 50322-2924
Mailing address
5500 Cody Dr
West Des Moines, IA 50266-6391
Phone (515) 267-1413
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18248 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780803213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 CODY DR",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502666391",
"telephone_number": "515-267-1413",
"fax_number": "515-270-2979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8515 DOUGLAS AVE",
"address_2": "SUITE 16",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503222924",
"telephone_number": "515-270-0713",
"fax_number": "515-270-2979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTON",
"first_name": "JENNNIFER",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "18248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.