James Nicholas Tisdell, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PST019166 Issued in LA

Practice address

3555 Greenwood Rd
Shreveport, LA 71109-5209

Phone

(318) 525-0144

NPI assigned

Sep 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Shreveport, LA
  • NPI 1134134307
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1316255136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 CHAMPION LAKE BLVD",
            "address_2": "APT. 1609",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053772",
            "telephone_number": "318-564-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 GREENWOOD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711095209",
            "telephone_number": "318-525-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDELL",
        "first_name": "JAMES",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST019166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Jean Tisby
• Matthew Joseph Tisby, M. DIV.
• Samaria Randle Tisby
• Anthony Tisdale
• Charles Girard Tisdale, PA-C
• Titan Prosthetics Inc
• TLM Diagnostics LLC
• TM Smith MD LLC
• John Rucker Todd IV, M.D.
• London Claire Todd, MD

• Pharmacist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.