Active NPI
Ann Moran, PHARM D
- Pharmacist
- Minneapolis, MN
National Provider Identifier
1801482393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123099
- Practice address
- 3930 Silver Lake Rd NE
Minneapolis, MN 55421-4351 - Phone
- (612) 781-6405
- NPI assigned
- Dec 18, 2020
- 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 | 123099 | MN | Primary |
Addresses
Primary practice location
3930 Silver Lake Rd NE
Minneapolis, MN 55421-4351
Mailing address
7483 161St Ave NW
Ramsey, MN 55303-4191
Phone (417) 872-5408
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123099 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supervalu Pharmacies Inc. | Past | Accepting new patients | |
| Supervalu Pharmacies 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608249600000",
"number": "1801482393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7483 161ST AVE NW",
"city": "RAMSEY",
"state": "MN",
"postal_code": "553034191",
"telephone_number": "417-872-5408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3930 SILVER LAKE RD NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554214351",
"telephone_number": "612-781-6405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "ANN",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-18",
"last_updated": "2020-12-18",
"certification_date": "2020-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.