Individual provider Active NPI

Tigist Edris

  • Pharmacist
  • Reynoldsburg, OH
National Provider Identifier
1548775810
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03127538 Issued in OH
Practice address
1000 Boyne CT
Reynoldsburg, OH 43068-6749
Phone
(614) 354-2477
NPI assigned
Dec 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03127538 OH Primary

Addresses

Primary practice location

1000 Boyne CT
Reynoldsburg, OH 43068-6749

Mailing address

1000 Boyne CT
Reynoldsburg, OH 43068-6749

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
03127538OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1548775810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BOYNE CT",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430686749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BOYNE CT",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430686749",
            "telephone_number": "614-354-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDRIS",
        "first_name": "TIGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03127538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.