Active NPI
Byron John Moon III, RPH
- Pharmacist
- Erie, PA
National Provider Identifier
1992412720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP044880L
- Practice address
- 4072 Appleberry Dr
Erie, PA 16510-6634 - Phone
- (814) 860-6338
- NPI assigned
- Nov 1, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP044880L | PA | Primary |
| Pharmacist | 183500000X | RPI016111 | PA |
Addresses
Primary practice location
4072 Appleberry Dr
Erie, PA 16510-6634
Mailing address
4072 Appleberry Dr
Erie, PA 16510-6634
Phone (814) 860-6338
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 |
|---|---|---|---|
| RP044880L | PA | MD | Pharmacist |
| RPI016111 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1992412720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4072 APPLEBERRY DR",
"city": "ERIE",
"state": "PA",
"postal_code": "165106634",
"telephone_number": "814-860-6338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4072 APPLEBERRY DR",
"city": "ERIE",
"state": "PA",
"postal_code": "165106634",
"telephone_number": "814-860-6338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "BYRON",
"middle_name": "JOHN",
"name_suffix": "III",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-01",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP044880L",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RPI016111",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.