Active NPI
Regan Nicole Tyler
- Pharmacist
- Jackson, MS
National Provider Identifier
1487208823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-16022
- Practice address
- 1497 Canton Mart Rd
Jackson, MS 39211-5435 - Phone
- (601) 956-2421
- NPI assigned
- Jul 24, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-16022 | MS | Primary |
Addresses
Primary practice location
1497 Canton Mart Rd
Jackson, MS 39211-5435
Mailing address
802 Lakeland Dr Apt 470
Jackson, MS 39216-4630
Phone (901) 413-8179
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | regan.tyler@walgreens.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| E-16022 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563926400000",
"number": "1487208823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 LAKELAND DR APT 470",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164630",
"telephone_number": "901-413-8179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1497 CANTON MART RD",
"city": "JACKSON",
"state": "MS",
"postal_code": "392115435",
"telephone_number": "601-956-2421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER",
"first_name": "REGAN",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-24",
"last_updated": "2019-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-16022",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "regan.tyler@walgreens.com",
"affiliation": "N",
"endpointDescription": "Walgreens corporate email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1497 Canton Mart Rd",
"city": "Jackson",
"state": "MS",
"country_code": "US",
"postal_code": "392115435",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.