Tyler William Mealy

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7356 Issued in OK

Practice address

1201 N Stonewall Ave Ste 206
Oklahoma City, OK 73117-1214

Phone

(405) 271-7744

NPI assigned

May 11, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 30, 2024 through May 30, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Charleston Oral Medicine, LLC

  • Dental Clinic/Center
  • Ladson, SC
  • NPI 1346925781
  NPD (past)

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1366064537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE STE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "201-835-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE STE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEALY",
        "first_name": "TYLER",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "7356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Jane Meadors, PHARMD
• Donald Wayne Meadows, PTA
• Jeff Meadows
• Kaili Meadows
• William Meadows
• Adele M Mears, DO
• Mecca House
• Mason Metz Mecke
• Med Hope Transport LLC
• Med One Stop, LLC

• Oral and Maxillofacial Surgery (Dentist) in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.