Active NPI
Tyler Coffey, RPH
- Pharmacist
- Johnson City, TN
National Provider Identifier
1114520384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 44402
- Practice address
- 4209 N Roan St
Johnson City, TN 37601-1114 - Phone
- (423) 292-5722
- NPI assigned
- Nov 19, 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 | 44402 | TN | Primary |
Addresses
Primary practice location
4209 N Roan St
Johnson City, TN 37601-1114
Mailing address
1709 Cherokee Rd Apt 205
Johnson City, TN 37604-7808
Phone (276) 219-7042
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44402 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1114520384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1709 CHEROKEE RD APT 205",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376047808",
"telephone_number": "276-219-7042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4209 N ROAN ST",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376011114",
"telephone_number": "423-292-5722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFEY",
"first_name": "TYLER",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "44402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.