Active NPI
Tyler Brian Walsh
- Pharmacist
- Bennington, VT
National Provider Identifier
1023739034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 033.0134778
- Practice address
- 8 Kocher Dr
Bennington, VT 05201-1923 - Phone
- (802) 442-8369
- NPI assigned
- Sep 7, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH241003 | MA | |
| Pharmacist | 183500000X | 033.0134778 | VT | Primary |
Addresses
Primary practice location
8 Kocher Dr
Bennington, VT 05201-1923
Mailing address
55 Veterans Memorial Dr
North Adams, MA 01247-2359
Phone (413) 664-8712
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH241003 | MA | MD | Pharmacist |
| 033.0134778 | VT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Current | Accepting new patients | |
| Vermont CVS Pharmacy, LLC | Past | Accepting new patients | |
| Vermont CVS Pharmacy LLC | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Locations
55 Veterans Memorial Dr
North Adams, MA 01247
Phone (413) 664-8712
Organizations & group practices 4
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": "1662508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714089600000",
"number": "1023739034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 VETERANS MEMORIAL DR",
"city": "NORTH ADAMS",
"state": "MA",
"postal_code": "012472359",
"telephone_number": "413-664-8712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 KOCHER DR",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052011923",
"telephone_number": "802-442-8369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "TYLER",
"middle_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-07",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH241003",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VT",
"license": "033.0134778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bennington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.