Active NPI
Tyrus Agee, OD
- Optometrist
- Fultondale, AL
National Provider Identifier
1689340564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- S-E91-TA-C39
- Practice address
- 3477 Lowery Pkwy Ste 137
Fultondale, AL 35068-1687 - Phone
- (205) 946-2720
- NPI assigned
- Aug 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | S-E91-TA-C39 | AL | Primary |
Addresses
Primary practice location
3477 Lowery Pkwy Ste 137
Fultondale, AL 35068-1687
Mailing address
1600 19TH St SW
Birmingham, AL 35211-4616
Phone (504) 650-4562
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
| License | State | Type | Specialty |
|---|---|---|---|
| S-E91-TA-C39 | AL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1689340564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 19TH ST SW",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352114616",
"telephone_number": "504-650-4562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3477 LOWERY PKWY STE 137",
"city": "FULTONDALE",
"state": "AL",
"postal_code": "350681687",
"telephone_number": "205-946-2720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGEE",
"first_name": "TYRUS",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-19",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "S-E91-TA-C39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fultondale, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.