Individual provider Active NPI

Tyrsa Lynne Creel, PHARMD

  • Pharmacist
  • Kings Mountain, NC
National Provider Identifier
1417364571
Registry record updated Mar 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24434 Issued in NC
Practice address
1011 Shelby Rd
Kings Mountain, NC 28086-2739
Phone
(704) 259-5229
Fax
(704) 259-5221
NPI assigned
Jul 21, 2014
Last updated
Mar 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24434 NC Primary

Addresses

Primary practice location

1011 Shelby Rd
Kings Mountain, NC 28086-2739

Mailing address

1011 Shelby Rd
Kings Mountain, NC 28086-2739
Phone (704) 259-5229

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
24434NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Mar 30, 2025 Accepting new patients
Wal-Mart Stores East, LP PastSince Mar 30, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742688000000",
    "number": "1417364571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SHELBY RD",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280862739",
            "telephone_number": "704-259-5229",
            "fax_number": "704-259-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 SHELBY RD",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280862739",
            "telephone_number": "704-259-5229",
            "fax_number": "704-259-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEL",
        "first_name": "TYRSA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2025-03-23",
        "certification_date": "2025-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "24434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2025; 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.