Active NPI
Chelsea Tyson, MD
- Pediatrics Physician
- Hurlburt Field, FL
National Provider Identifier
1215591854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101272019
- Practice address
- 113 Lielmanis Ave
Hurlburt Field, FL 32544-5613 - Phone
- (850) 881-3123
- NPI assigned
- Apr 29, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101272019 | VA | Primary |
Addresses
Primary practice location
113 Lielmanis Ave
Hurlburt Field, FL 32544-5613
Mailing address
2335 Cummings Dr
Fort Walton Beach, FL 32547-2476
Phone (501) 690-4588
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101272019 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1215591854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2335 CUMMINGS DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325472476",
"telephone_number": "501-690-4588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 LIELMANIS AVE",
"city": "HURLBURT FIELD",
"state": "FL",
"postal_code": "325445613",
"telephone_number": "850-881-3123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYSON",
"first_name": "CHELSEA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-29",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101272019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurlburt Field, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.