Individual provider Active NPI

Tamara Y Moore, PHARM D

  • Pharmacist
  • Cedar Rapids, IA
National Provider Identifier
1962784348
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24114 Issued in IA
Practice address
3601 29TH Ave SW
Cedar Rapids, IA 52404-3109
Phone
(319) 390-9925
Fax
(573) 875-1097
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2012024154 MO
Pharmacist 183500000X 24114 IA Primary
Pharmacist 183500000X 03127283 OH

Addresses

Primary practice location

3601 29TH Ave SW
Cedar Rapids, IA 52404-3109

Mailing address

3601 29TH Ave SW
Cedar Rapids, IA 52404-3109
Phone (319) 390-9925

Other identifiers 1

IdentifierTypeStateIssuer
24114OtherIAIOWA BOARD OF PHARMACY

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
2012024154MOMDPharmacist
03127283OHMDPharmacist
24114IAMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1962784348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 29TH AVE SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043109",
            "telephone_number": "319-390-9925",
            "fax_number": "319-390-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 29TH AVE SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043109",
            "telephone_number": "319-390-9925",
            "fax_number": "573-875-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TAMARA",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2012024154",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "24114",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03127283",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA BOARD OF PHARMACY",
            "identifier": "24114",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.