Individual provider Active NPI

Shelton T Tyler, MOA

  • Diplomate Laboratory Management Specialist/Technologist
  • North Augusta, SC
National Provider Identifier
1679419535
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diplomate Laboratory Management Specialist/TechnologistTaxonomy code 246QL0901X
Practice address
725 E Martintown Rd Ste 6
North Augusta, SC 29841-4239
Phone
(839) 839-5422
NPI assigned
Apr 24, 2026
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diplomate Laboratory Management Specialist/Technologist 246QL0901X SC Primary

Addresses

Primary practice location

725 E Martintown Rd Ste 6
North Augusta, SC 29841-4239

Mailing address

725 E Martintown Rd Ste 6
North Augusta, SC 29841-4239
Phone (839) 839-5422

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

NPI Registry JSON

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

{
    "created_epoch": "1776988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1679419535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E MARTINTOWN RD STE 6",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298414239",
            "telephone_number": "839-839-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E MARTINTOWN RD STE 6",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298414239",
            "telephone_number": "839-839-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "SHELTON",
        "middle_name": "T",
        "credential": "MOA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-24",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0901X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management, Diplomate",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Augusta, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.