Active NPI
Ryan Anthony Myslakowski, PHARM.D.
- Pharmacist
- Dyersburg, TN
National Provider Identifier
1154706125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39463
- Practice address
- 2615 Lake Rd
Dyersburg, TN 38024-1605 - Phone
- (731) 288-5065
- Fax
- (731) 288-6136
- NPI assigned
- Jul 20, 2015
- Last updated
- Jul 20, 2015
- 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 | 39463 | TN | Primary |
Addresses
Primary practice location
2615 Lake Rd
Dyersburg, TN 38024-1605
Mailing address
2615 Lake Rd
Dyersburg, TN 38024-1605
Phone (731) 288-5065
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39463 | TN | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437350400000",
"number": "1154706125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 LAKE RD",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380241605",
"telephone_number": "731-288-5065",
"fax_number": "731-288-6136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 LAKE RD",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380241605",
"telephone_number": "731-288-5065",
"fax_number": "731-288-6136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYSLAKOWSKI",
"first_name": "RYAN",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-20",
"last_updated": "2015-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "39463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyersburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.