Ty Macwalters, CPHT

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

037.0001187 Issued in VT

Practice address

130 Fisher Road
Central Vermont Medical Center
Berlin, VT 05602-0560

Phone

(802) 371-4857

Fax

(802) 371-4408

NPI assigned

Jul 13, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679095475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER ROAD",
            "address_2": "CENTRAL VERMONT MEDICAL CENTER",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056020560",
            "telephone_number": "802-371-4857",
            "fax_number": "802-371-4408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Fisher Rd",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "VT",
            "postal_code": "056029516",
            "country_code": "US",
            "telephone_number": "802-371-4857",
            "fax_number": "802-371-4408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACWALTERS",
        "first_name": "TY",
        "credential": "CPHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "VT",
            "license": "037.0001187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "121.0000650",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Sarah Lorenz-Greenberg, MD
• Christopher Joseph Lukonis, M.D.
• Donald F. Lynch, MD
• Gregory J Macdonald, MD
• Jessica L Macleod, APRN
• Nancy Mahoney, MS, CCC-SLP
• Beth Ann Maier, M.D.
• Marvin Keith Malek, MD
• Melissa G Marcellino, LMHC
• Mark E. Crane MD, LLC

• Institutional Pharmacy in Berlin, VT
• Providers in Berlin, VT by specialty
• Institutional Pharmacy in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.