Active NPI
Jake Mossman, RPH
- Pharmacist
- Taos, NM
National Provider Identifier
1891756185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4584
- Practice address
- 622 Paseo del Pueblo Sur
5401 Ndcbu
Taos, NM 87571-5101 - Phone
- (505) 758-3342
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- 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 | 4584 | NM | Primary |
Addresses
Primary practice location
622 Paseo del Pueblo Sur
5401 Ndcbu
Taos, NM 87571-5101
Mailing address
PO Box 942
El Prado, NM 87529-0942
Phone (505) 758-8336
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 |
|---|---|---|---|
| 4584 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1891756185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 942",
"city": "EL PRADO",
"state": "NM",
"postal_code": "875290942",
"telephone_number": "505-758-8336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 PASEO DEL PUEBLO SUR",
"address_2": "5401 NDCBU",
"city": "TAOS",
"state": "NM",
"postal_code": "875715101",
"telephone_number": "505-758-3342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSSMAN",
"first_name": "JAKE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "4584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.