Active NPI
Tyler Dalton Nealy, PHARMD
- Pharmacist
- Villa Rica, GA
National Provider Identifier
1649860404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH032124
- Practice address
- 736 Hwy 78 West
Villa Rica, GA 30180-3018 - Phone
- (770) 459-8234
- NPI assigned
- Jan 25, 2021
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH032124 | GA | Primary |
Addresses
Primary practice location
736 Hwy 78 West
Villa Rica, GA 30180-3018
Mailing address
736 Hwy 78 West
Villa Rica, GA 30180
Phone (770) 459-8234
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH032124 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611532800000",
"number": "1649860404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "736 HWY 78 WEST",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "30180",
"telephone_number": "770-459-8234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 HWY 78 WEST",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301803018",
"telephone_number": "770-459-8234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEALY",
"first_name": "TYLER",
"middle_name": "DALTON",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-25",
"last_updated": "2021-01-25",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH032124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Rica, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.