Active NPI
Tamara Y Moore, PHARM D
- Pharmacist
- Cedar Rapids, IA
National Provider Identifier
1962784348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24114
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24114 | Other | IA | IOWA 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2012024154 | MO | MD | Pharmacist |
| 03127283 | OH | MD | Pharmacist |
| 24114 | IA | MD | Orthopaedic 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.