Susan Chandler Tyler, CBS, DIPLOMATE, CNC

Primary specialty

SpecialistTaxonomy code 174400000X

License

CERTIFICATE 3592 DQT Issued in NC

Practice address

268 New Bridge Rd
Glide, OR 97443-9609

Phone

(541) 733-4207

Fax

(888) 629-4949

NPI assigned

Oct 14, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1194050831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 NEW BRIDGE RD",
            "city": "GLIDE",
            "state": "OR",
            "postal_code": "974439609",
            "telephone_number": "541-733-4207",
            "fax_number": "888-629-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 NEW BRIDGE RD",
            "city": "GLIDE",
            "state": "OR",
            "postal_code": "974439609",
            "telephone_number": "541-733-4207",
            "fax_number": "888-629-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "SUSAN",
        "middle_name": "CHANDLER",
        "name_prefix": "Mrs.",
        "credential": "CBS, DIPLOMATE, CNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "CA",
            "license": "CERTIFICATION ONLY",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "CERTIFICATE 3592 DQT",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "SHC 1073",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "CERTIFICATE 3592 QBS",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Springs Health LLC
• Toni Lynn Hurlocker, PMHNP-BC
• Lucinda Kaul, LMT
• Oregon Mobile Physical Therapy
• Garrett Corrigan Stroup
• Umpqua Community Health Center, Inc.

• All providers in Glide, OR
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.