Active NPI
Tyler Nickel, PHARMD
- Pharmacist
- Oshkosh, WI
National Provider Identifier
1033743604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17701-40
- Practice address
- 1100 Emmers LN
Oshkosh, WI 54904-7758 - Phone
- (920) 237-4753
- Fax
- (920) 237-4756
- NPI assigned
- Feb 23, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17701-40 | WI | Primary |
Addresses
Primary practice location
1100 Emmers LN
Oshkosh, WI 54904-7758
Mailing address
1100 Emmers LN
Oshkosh, WI 54904-7758
Phone (920) 237-4753
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 |
|---|---|---|---|
| 17701-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582416000000",
"number": "1033743604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 EMMERS LN",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549047758",
"telephone_number": "920-237-4753",
"fax_number": "920-237-4756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 EMMERS LN",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549047758",
"telephone_number": "920-237-4753",
"fax_number": "920-237-4756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKEL",
"first_name": "TYLER",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-23",
"last_updated": "2020-02-23",
"certification_date": "2020-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "17701-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oshkosh, WI
- New Haven, Inc (Arborview Manor, Oakwood Manor, Webster Manor)
- John B Newman, MD
- Kimberly Nichols-Green, BCBA
- Heather Anne Nicholson, C.A, M.AC, DIPL.AC.
- Bonnie L Nickasch, APNP
- Allison Nierode, CRNA
- Jamie Lynn Noble, M.S., CCC/SLP
- Matthew Thomas Nockerts, PT
- Jessica L Nokovic, D.O.
- Michaela Norby, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.