Tyler Derrick, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

23123 Issued in AL

Practice address

3201 Endeavor LN
Vestavia, AL 35242-8250

Phone

(205) 421-2983

NPI assigned

Jul 3, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Publix Alabama, LLC

  • Community/Retail Pharmacy
  • Vestavia Hills, AL
  • NPI 1447894175
  NPD

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1083391940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 BOXWOOD CT",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352164691",
            "telephone_number": "205-471-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 ENDEAVOR LN",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352428250",
            "telephone_number": "205-421-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "23123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teague Willson Delmas, PT
• Rachel Reynolds Demers
• Caitlin Campbell Denton, LPC
• Lacey Denton, CRNA
• Laura Lynn Denver, PT
• Molleen Kofman Desai, CRNP
• Deshazo Medical
• Ashton Brooke Devore
• Melissa Ann Dixon, PHARMD
• DKM Pharmcare LLC

• Pharmacist in Vestavia, AL
• Providers in Vestavia, AL by specialty
• Pharmacist in Alabama

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