Individual provider Active NPI

Faith A Tyler, FNP

  • Family Nurse Practitioner
  • Fayetteville, WV
National Provider Identifier
1396916722
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61829 Issued in WV
Practice address
RR 3 Box 9
439 Elizabeth Way
Fayetteville, WV 25840-9505
Phone
(304) 574-2600
Fax
(304) 574-2951
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 61829 WV Primary

Addresses

Primary practice location

RR 3 Box 9
439 Elizabeth Way
Fayetteville, WV 25840-9505

Mailing address

RR 3 Box 9
439 Elizabeth Way
Fayetteville, WV 25840-9505
Phone (304) 574-2600

Other practice location 1

5447 Maple Ln Ste B
Fayetteville, WV 25840-6872
Phone (304) 658-9397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080513000102 WV Practitioner - Nurse Practitioner 1052480357 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Nov 29, 2023 Accepting new patients
Cherokee Emergency Services, Inc. CurrentSince Nov 1, 2010 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

124 Brookshire Ln
Beckley, WV 25801
Phone (304) 252-8551

Interoperability endpoints

  • Direct secure messaging: ftyler@yourcarecommunity.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1396916722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 9",
            "address_2": "439 ELIZABETH WAY",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258409505",
            "telephone_number": "304-574-2600",
            "fax_number": "304-574-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 9",
            "address_2": "439 ELIZABETH WAY",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258409505",
            "telephone_number": "304-574-2600",
            "fax_number": "304-574-2951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5447 Maple Ln Ste B",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "WV",
            "postal_code": "258406872",
            "country_code": "US",
            "telephone_number": "304-658-9397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "FAITH",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "61829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, WV

Sources for this page

Verify at the official NPI Registry.