Individual provider Active NPI

Tyler Jake Stromberg

  • Pharmacist
  • Cheyenne, WY
National Provider Identifier
1154936110
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4243 Issued in WY
Practice address
1501 Dell Range Blvd
Cheyenne, WY 82009-4853
Phone
(307) 635-5854
NPI assigned
Sep 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4243 WY Primary

Addresses

Primary practice location

1501 Dell Range Blvd
Cheyenne, WY 82009-4853

Mailing address

2218 Hummingbird TRL
Cheyenne, WY 82009-9179
Phone (432) 213-2394

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

State licenses

LicenseStateTypeSpecialty
4243WYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Feb 27, 2022 Accepting new patients
Walgreen Co PastSince Sep 20, 2020 Accepting new patients

Locations

1501 Dell Range Blvd
Cheyenne, WY 82009
Phone (307) 635-5854

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1154936110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 HUMMINGBIRD TRL",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820099179",
            "telephone_number": "432-213-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 DELL RANGE BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094853",
            "telephone_number": "307-635-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROMBERG",
        "first_name": "TYLER",
        "middle_name": "JAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "4243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.

Verify at the official NPI Registry.