Individual provider Active NPI

James Durward Tyler III, APRN

  • Family Nurse Practitioner
  • Marianna, FL
National Provider Identifier
1043775133
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9344996 Issued in FL
Practice address
4230 Hospital Dr Ste 210
Marianna, FL 32446-1955
Phone
(850) 526-6735
NPI assigned
Feb 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9344996 FL Primary

Addresses

Primary practice location

4230 Hospital Dr Ste 210
Marianna, FL 32446-1955

Mailing address

4250 Hospital Dr
Marianna, FL 32446-1917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190401000976 FL Practitioner - Nurse Practitioner 1759622780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER Physician Group at Jackson HospitalGroup PAC ID 8729059472, 153 clinicians

Practice addresses (Care Compare)

4250 Hospital Dr
Marianna, FL 32446-1917
Phone (850) 526-2200

Hospital & facility affiliations

  • Concierge Home Care Home health agency, Panama City, FL, CCN 687029
  • Centerwell Home Health Home health agency, Marianna, FL, CCN 109102
  • Jackson Hospital Hospital, Marianna, FL, CCN 100142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
ER Physician Group at Jackson Hospital CurrentSince Mar 4, 2019 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

4296 5th Ave
Marianna, FL 32446
Phone (850) 482-2061

4230 Hospital Dr
Ste 210
Marianna, FL 32446
Phone (850) 526-3434

4250 Hospital Dr
Marianna, FL 32446
Phone (850) 526-2200

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1043775133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 HOSPITAL DR",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HOSPITAL DR STE 210",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461955",
            "telephone_number": "850-526-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "JAMES",
        "middle_name": "DURWARD",
        "name_suffix": "III",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-04",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9344996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.