Individual provider Active NPI

Bradley Moriarty, PHARMD

  • Pharmacist
  • Galesburg, IL
National Provider Identifier
1811271265
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.294419 Issued in IL
Practice address
1057 E Main St
Galesburg, IL 61401-3973
Phone
(309) 341-2424
NPI assigned
Oct 4, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.294419 IL Primary

Addresses

Primary practice location

1057 E Main St
Galesburg, IL 61401-3973

Mailing address

1057 E Main St
Galesburg, IL 61401-3973

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

LicenseStateTypeSpecialty
051.294419ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1811271265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 E MAIN ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614013973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 E MAIN ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614013973",
            "telephone_number": "309-341-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIARTY",
        "first_name": "BRADLEY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.294419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.