NPIMap

Individual provider Active NPI

Tyler Bertsch

  • Pharmacist
  • Longmont, CO
National Provider Identifier
1437686151
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21293 Issued in CO
Practice address
1630 Pace St
Longmont, CO 80504-2119
Phone
(303) 485-9700
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

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

State licenses

LicenseStateTypeSpecialty
21293COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
County Drug Current Accepting new patients
Deadwood Drug Inc Current Accepting new patients
County Drug Inc Current Accepting new patients
Safeway Inc Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21293 CO Primary

Addresses

NPPES NPI Registry

Primary practice location

1630 Pace St
Longmont, CO 80504-2119

Mailing address

1630 Pace St
Longmont, CO 80504-2119
Phone (303) 485-9700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2017.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1437686151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 PACE ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805042119",
            "telephone_number": "303-485-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 PACE ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805042119",
            "telephone_number": "303-485-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCH",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "21293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.