Active NPI
Tyler Davis, PHARMD
- Ambulatory Care Pharmacist
- Paynesville, MN
National Provider Identifier
1508771239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 127506
- Practice address
- 200 W 1St St
Paynesville, MN 56362-1445 - Phone
- (320) 243-7702
- NPI assigned
- Aug 17, 2026
- Sex
- Unspecified or another gender identity
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 127506 | MN | Primary |
Addresses
Primary practice location
200 W 1St St
Paynesville, MN 56362-1445
Mailing address
13983 Hollyhock LN
Rogers, MN 55374-8878
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1786924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1508771239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13983 HOLLYHOCK LN",
"city": "ROGERS",
"state": "MN",
"postal_code": "553748878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W 1ST ST",
"city": "PAYNESVILLE",
"state": "MN",
"postal_code": "563621445",
"telephone_number": "320-243-7702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TYLER",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-08-17",
"last_updated": "2026-08-17",
"certification_date": "2026-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "MN",
"license": "127506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paynesville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.