Active NPI
Tyler Dahl
- Pharmacist
- Saint Marys, PA
National Provider Identifier
1053890483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP450875
- Practice address
- 4 Railroad St
Saint Marys, PA 15857-1798 - Phone
- (814) 834-3017
- NPI assigned
- Aug 7, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | RP450875 | PA | |
| Pharmacist | 183500000X | 03135948 | OH | |
| Pharmacist | 183500000X | RP450875 | PA | Primary |
Addresses
Primary practice location
4 Railroad St
Saint Marys, PA 15857-1798
Mailing address
144 Airport Rd
Saint Marys, PA 15857-3047
Phone (814) 389-6881
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 |
|---|---|---|---|
| RP450875 | PA | MD | Diabetes Educator Registered Nurse |
| 03135948 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592524800000",
"number": "1053890483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 AIRPORT RD",
"city": "SAINT MARYS",
"state": "PA",
"postal_code": "158573047",
"telephone_number": "814-389-6881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 RAILROAD ST",
"city": "SAINT MARYS",
"state": "PA",
"postal_code": "158571798",
"telephone_number": "814-834-3017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-07",
"last_updated": "2020-06-19",
"certification_date": "2020-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "PA",
"license": "RP450875",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03135948",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP450875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Marys, PA
- Cooper Dialysis LLC (Elk Regional Dialysis)
- Jolene Marie Cortina, DPT
- Erica Lee Costanzo
- Kerri Marie Coudriet, OTR/L
- Jessica Lynn Cunningham, M.S., CCC-SLP
- Daniel D. Jones,D.C. (St. Marys Chiropractic Center)
- David G. Sanderson, DPM, PC
- Delhunty Chiropractic Health & Wellness, PLLC.
- Brandon Michael Delhunty, D.C.
- Kevin Destephano, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.