Active NPI
Tyler Smith, PHARM D.
- Pharmacist
- Mountain BRK, AL
National Provider Identifier
1174122998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21345
- Practice address
- 4476 Montevallo Rd
Mountain BRK, AL 35213-1519 - Phone
- (205) 951-9711
- NPI assigned
- Oct 22, 2020
- Last updated
- Oct 26, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15024 | MS | |
| Pharmacist | 183500000X | 21345 | AL | Primary |
Addresses
Primary practice location
4476 Montevallo Rd
Mountain BRK, AL 35213-1519
Mailing address
5751 9TH Ave S
Birmingham, AL 35212-4007
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 |
|---|---|---|---|
| 21345 | AL | MD | Pharmacist |
| 15024 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1174122998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5751 9TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352124007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4476 MONTEVALLO RD",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352131519",
"telephone_number": "205-951-9711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "TYLER",
"credential": "PHARM D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-22",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "15024",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "21345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain BRK, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.