Individual provider Active NPI

Tyler Joseph Lemke, PHARMD

  • Pharmacist
  • Loudonville, NY
National Provider Identifier
1336758713
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
I065846-01 Issued in NY
Practice address
463 Albany Shaker Rd
Loudonville, NY 12211-1833
Phone
(518) 477-8166
NPI assigned
Jul 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X I065846-01 NY Primary

Addresses

Primary practice location

463 Albany Shaker Rd
Loudonville, NY 12211-1833

Mailing address

614 Columbia Tpke
East Greenbush, NY 12061-1610
Phone (518) 479-4230

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL rxm.19865@store.walgreens.com Direct WALGREENS

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

LicenseStateTypeSpecialty
I065846-01NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1336758713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 COLUMBIA TPKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120611610",
            "telephone_number": "518-479-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 ALBANY SHAKER RD",
            "city": "LOUDONVILLE",
            "state": "NY",
            "postal_code": "122111833",
            "telephone_number": "518-477-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMKE",
        "first_name": "TYLER",
        "middle_name": "JOSEPH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-30",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "I065846-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rxm.19865@store.walgreens.com",
            "affiliation": "Y",
            "endpointDescription": "Pharmacy Email",
            "affiliationName": "WALGREENS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1645 Columbia Tpke",
            "city": "Castleton ON Hudson",
            "state": "NY",
            "country_code": "US",
            "postal_code": "120339535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loudonville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.