Tyler Lane Qualls, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1147 Issued in MS

Practice address

7651 Tchulahoma Rd
Southaven, MS 38671-9227

Phone

(662) 349-0980

Fax

(662) 349-0990

NPI assigned

Apr 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Mississippi Upper Cervical Clinic, IncGroup PAC ID 6507910825, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mississippi Upper Cervical Clinic, Inc

  • Chiropractor
  • Southaven, MS
  • NPI 1346318797
  Medicare reassignment Care Compare group
• Midsouth Integrative Medical, Inc

  • Primary Care Clinic/Center
  • Southaven, MS
  • NPI 1568089993
  NPD (past)

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1154565794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7651 TCHULAHOMA RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719227",
            "telephone_number": "662-349-0980",
            "fax_number": "662-349-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7651 TCHULAHOMA RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719227",
            "telephone_number": "662-349-0980",
            "fax_number": "662-349-0990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1973 Oak Tree Cv",
            "address_purpose": "LOCATION",
            "city": "Hernando",
            "state": "MS",
            "postal_code": "386321536",
            "country_code": "US",
            "telephone_number": "662-349-0980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "TYLER",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-27",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I355410",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Grady Putnam, MD
• Muneeba Qayyum, MD
• Quality Drug Testing, LLC
• Quality Foot Care LLC
• Trevor Lamar Qualls, D.C.
• Jared Quave
• Quinn Quality Home Health, LLC
• Rad-One, PA
• Shane Radford, DMD
• Leslie Michelle Raggett, DNP

• Chiropractor in Southaven, MS
• Providers in Southaven, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.