Individual provider Active NPI

Tyler Coomes

  • Pharmacist
  • Bardstown, KY
National Provider Identifier
1013795848
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
023856 Issued in KY
Practice address
202 W Stephen Foster Ave
Bardstown, KY 40004-1478
Phone
(502) 348-6623
NPI assigned
Sep 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 023856 KY Primary

Addresses

Primary practice location

202 W Stephen Foster Ave
Bardstown, KY 40004-1478

Mailing address

600 Equinox Blvd
Mount Washington, KY 40047-6538
Phone (502) 428-7870

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

State licenses

LicenseStateTypeSpecialty
023856KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1013795848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 EQUINOX BLVD",
            "city": "MOUNT WASHINGTON",
            "state": "KY",
            "postal_code": "400476538",
            "telephone_number": "502-428-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W STEPHEN FOSTER AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041478",
            "telephone_number": "502-348-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMES",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "023856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardstown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.