Active NPI
Jonathan Andrew Moe, PHARMD
- Pharmacist
- Riverview, FL
National Provider Identifier
1942570767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS47732
- Practice address
- 10427 Big Bend Rd
Riverview, FL 33578-7415 - Phone
- (813) 347-5023
- Fax
- (813) 347-5050
- NPI assigned
- Jan 10, 2012
- Last updated
- Jan 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | PS47732 | FL | Primary |
Addresses
Primary practice location
10427 Big Bend Rd
Riverview, FL 33578-7415
Mailing address
4883 Pond Ridge Dr
Riverview, FL 33578-2106
Phone (919) 272-5525
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 |
|---|---|---|---|
| PS47732 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1942570767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4883 POND RIDGE DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335782106",
"telephone_number": "919-272-5525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10427 BIG BEND RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335787415",
"telephone_number": "813-347-5023",
"fax_number": "813-347-5050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOE",
"first_name": "JONATHAN",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-10",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS47732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.