Active NPI
Joel L Tyser, CRNA
- Certified Registered Nurse Anesthetist
- Fulton, MO
National Provider Identifier
1598745929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 078835
- Practice address
- 10 South Hospital Drive
Fulton, MO 65251 - Phone
- (573) 642-3376
- Fax
- (573) 592-6679
- NPI assigned
- Jan 20, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 078835 | MO | Primary |
Addresses
Primary practice location
10 South Hospital Drive
Fulton, MO 65251
Mailing address
10 South Hospital Drive
Fulton, MO 65251
Phone (573) 642-3376
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN078835 | Other | MO | MISSOURI STATE LICENSE NU |
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 078835 | MO | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1598745929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 SOUTH HOSPITAL DRIVE",
"city": "FULTON",
"state": "MO",
"postal_code": "65251",
"telephone_number": "573-642-3376",
"fax_number": "573-592-6679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 SOUTH HOSPITAL DRIVE",
"city": "FULTON",
"state": "MO",
"postal_code": "65251",
"telephone_number": "573-642-3376",
"fax_number": "573-592-6679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYSER",
"first_name": "JOEL",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-20",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "078835",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSOURI STATE LICENSE NU",
"identifier": "RN078835",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.