Individual provider Active NPI

Tyler Newsome

  • Pharmacist
  • New London, CT
National Provider Identifier
1568197754
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0016081 Issued in CT
Practice address
698 Bank St
New London, CT 06320-5040
Phone
(860) 440-3566
NPI assigned
Jul 21, 2022
Last updated
Oct 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0016081 CT Primary

Addresses

Primary practice location

698 Bank St
New London, CT 06320-5040

Mailing address

698 Bank St
New London, CT 06320-5040

Other names 1

  • Tyler Richards Former name

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
PCT.0016081CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jul 24, 2022 Accepting new patients
Walgreen Co PastSince Jul 24, 2022 Accepting new patients

Locations

698 Bank St
New London, CT 06320
Phone (860) 440-3566

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1568197754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 BANK ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 BANK ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205040",
            "telephone_number": "860-440-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOME",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0016081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "RICHARDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.