Individual provider Active NPI

Tyrel Long, PHARMD

  • Pharmacist
  • Layton, UT
National Provider Identifier
1558116160
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8665125-1701 Issued in UT
Practice address
1492 W Antelope Dr
Layton, UT 84041-1139
Phone
(801) 825-3879
NPI assigned
Apr 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8665125-1701 UT Primary

Addresses

Primary practice location

1492 W Antelope Dr
Layton, UT 84041-1139

Mailing address

3963 N 550 W
Pleasant View, UT 84414-1042
Phone (801) 866-7223

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
8665125-1701UTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1558116160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3963 N 550 W",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844141042",
            "telephone_number": "801-866-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 W ANTELOPE DR",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411139",
            "telephone_number": "801-825-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "TYREL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "8665125-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.