Individual provider Active NPI

Tyler Jeffrey Glisson, FNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Asheville, NC
National Provider Identifier
1124555453
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5012666 Issued in NC
Practice address
356 Biltmore Ave
Asheville, NC 28801-4504
Phone
(828) 254-2700
NPI assigned
May 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5012666 NC Primary
Family Nurse Practitioner 363LF0000X 9347781 FL

Addresses

Primary practice location

356 Biltmore Ave
Asheville, NC 28801-4504

Mailing address

356 Biltmore Ave
Asheville, NC 28801-4504
Phone (828) 318-5241

Other practice location 1

650 Huebner Rd
Fort Riley, KS 66442-4030
Phone (785) 239-7151

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9347781FLMDFamily Nurse Practitioner
5012666NCMDPsychiatric/Mental Health Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21115/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1124555453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 BILTMORE AVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014504",
            "telephone_number": "828-318-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 BILTMORE AVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014504",
            "telephone_number": "828-254-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Huebner Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Riley",
            "state": "KS",
            "postal_code": "664424030",
            "country_code": "US",
            "telephone_number": "785-239-7151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLISSON",
        "first_name": "TYLER",
        "middle_name": "JEFFREY",
        "credential": "FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012666",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9347781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.