Individual provider Active NPI

Dylan Tomblin, PHARMD

  • Pharmacist
  • Buckhannon, WV
National Provider Identifier
1700486156
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0010272 Issued in WV
Practice address
100 Buckhannon XRDS
Buckhannon, WV 26201-8422
Phone
(304) 472-0834
NPI assigned
Oct 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP0010272 WV Primary

Addresses

Primary practice location

100 Buckhannon XRDS
Buckhannon, WV 26201-8422

Mailing address

100 Buckhannon XRDS
Buckhannon, WV 26201-8422
Phone (304) 472-0834

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

LicenseStateTypeSpecialty
RP0010272WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1700486156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BUCKHANNON XRDS",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262018422",
            "telephone_number": "304-472-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BUCKHANNON XRDS",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262018422",
            "telephone_number": "304-472-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMBLIN",
        "first_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0010272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckhannon, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.