Active NPI
Tyler Trisdale
- Pharmacist
- Dunlap, TN
National Provider Identifier
1205385739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 40491
- Practice address
- 14978 Rankin Ave
Dunlap, TN 37327-7006 - Phone
- (423) 949-4049
- NPI assigned
- Sep 26, 2016
- Last updated
- Sep 26, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 40491 | TN | Primary |
Addresses
Primary practice location
14978 Rankin Ave
Dunlap, TN 37327-7006
Mailing address
1940 Gainesboro Hwy
Baxter, TN 38544-3706
Phone (931) 239-5381
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40491 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1205385739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1940 GAINESBORO HWY",
"city": "BAXTER",
"state": "TN",
"postal_code": "385443706",
"telephone_number": "931-239-5381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14978 RANKIN AVE",
"city": "DUNLAP",
"state": "TN",
"postal_code": "373277006",
"telephone_number": "423-949-4049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRISDALE",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-26",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "40491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunlap, TN
- Summit Health & Wellness LLC
- Tennessee Em-I Medical Services PC
- Tennessee River Physicians, PLLC
- Tennessee Valley Primary Care, PLLC
- Robert Brett Thompson, MS SLP- CCC
- Alexis K Turner, PTA
- Savannah Faith Turner, LPN
- Wal-Mart Stores East LP (Walmart Pharmacy 10-4226)
- Walgreen Co (Rite Aid #1151)
- Walgreen Co (Walgreens #11670)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.